Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Comparing the impact of bilateral erector spinae plane block and transverse abdominis plane block on improving quality of pain management after umbilical hernia repair.
Postoperative pain is an important problem after umbilical hernia repair which has negative effects on patient's hemodynamics and cause delayed ambulation resulting in prolonged duration of hospital stay and poor patient satisfaction.
Multiple analgesic strategies have been proposed including Non steroidal anti-inflammatory drugs (NSAIDs), opioids, epidural analgesia. Each of them has its limitations.
Ultra¬sound guided regional anesthesia techniques for abdominal wall can be effective components of multimodal postoperative analgesia with limited side-effects Erector spinae plane (ESP) block is a promising para-spinal bock that can achieve both visceral and somatic abdominal analgesia if the injection was performed at a lower thoracic level. Transverse abdominis plane (TAP) block which is considered a peripheral nerve block that is aimed at anesthetizing nerves supplying the anterior abdominal wall.
We will compare between erector spinae plane block and transverse abdominis plane block for controlling postoperative pain after umbilical hernia repair.
Patients will be allocated randomly into two equal groups by a computer-generated randomization table Group (E) (n=26): Patients will receive erector spinae plane (ESP) block after completion of surgery.
Group (T) (n= 26): Patients will receive oblique subcostal transverse abdominis plane (TAP) block after completion of surgery
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| erector spinae plane (ESP) block group ( (E) group) | Active Comparator | Under aseptic conditions, a high frequency linear transducer will be placed on the spinous process at T8 level on the parasagittal plane and then slid 2.5-3 cm laterally to visualize the transverse process and erector spinae muscle. |
|
| oblique subcostal transverse abdominis plane (TAP) block ( (T) group) ) | Active Comparator | Under aseptic conditions, the probe will be initially placed below the xyphoid process to view the linea alba, then directed obliquely down the costal margin while keeping the rectus abdominis muscle in view. The transverse abdominis muscle come into view below the rectus abdominis muscle. The probe will be advanced further until the semilunaris is viewed. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| erector spinae plane (ESP) block | Procedure | Using the in plane technique, the needle will be advanced between the transverse process and erector spinae muscle. The correct location will be confirmed using 1ml of Local Anesthetic (LA) to view hydrodissection(12). 19ml of LA will be injected between the muscle and transverse process. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative analgesic requirements | measuring the total doses of analgesic required to relieve the pain | 24 hours postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative pain severity using Visual Analogue scale | assessing pain severity using Visual Analogue scale (VAS) (0-100mm) | 24 hours postoperative |
| Postoperative pain severity using Verbal Rating Scale |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| michael A shaker, lecturer | Contact | 01096457282 | 002 | michaeladelshaker@gamil.com |
| salwa s ElSherbeny, lecturer | Contact | 01128595629 | 002 |
| Name | Affiliation | Role |
|---|---|---|
| Michael A shaker, lecturer | Zagazig University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Zagazig University hospital | Recruiting | Zagazig | Sharqia Province | 44511 | Egypt |
Not provided
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
Not provided
Not provided
| ID | Term |
|---|---|
| D010268 | Parapsychology |
| D003766 | Dental Occlusion |
| ID | Term |
|---|---|
| D001525 | Behavioral Sciences |
| D004191 | Behavioral Disciplines and Activities |
| D003813 | Dentistry |
| D009063 | Dental Physiological Phenomena |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
|
| oblique subcostal transverse abdominis plane (TAP) block | Procedure | An echogenic needle will be inserted in-plane until the needle tip reaches the fascia between the rectus abdominis and the transverse abdominis muscles. Once the needle enters the TAP plane, a dynamic injection can be performed by advancing the needle under ultrasound guidance laterally in the pocket created by the initial injection of 5 - 10 mL of local anesthetic; as the needle is advanced, the remaining local anesthetic will be injected. This allows for a more lateral spread of the local anesthetic |
|
assessing pain severity using Verbal Rating Scale (mild, moderate and severe)
| 24 hours postoperative |
| Postoperative pain severity using Numeric Rating Scale | assessing pain severity using Numeric Rating Scale (NRS) (0-10; 0, no pain; 10, worst pain) | 24 hours postoperative |
| Postoperative heart rate changes | monitoring postoperative changes in the heart rate (HR) measured by beat per minute (BPM) and comparing it with the preoperative measures | 24 hours postoperative |
| Postoperative blood pressure changes | monitoring postoperative changes in the blood pressure (BP) measured by mm Hg and comparing it with the preoperative measures. | 24 hours postoperative |
| Incidence of postoperative side effects | recording any postoperative complications as nausea and vomiting | 24 hours postoperative |
| Duration of postoperative hospital stay | measuring the delay in discharging the patients postoperative because of the pain | 24 hours postoperative |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D055688 | Digestive System and Oral Physiological Phenomena |