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Since TAP block needs to affect several nerves in single tissue plane with a single prick, hyaluronidase is expected to aid greatly in the spread of the LA and help the block. However, there have not been adequate studies to establish the efficacy of adding hyaluronidase in lateral TAP after cesarean section. Hence, the present study was carried out to evaluate the efficacy of hyaluronidase in different concentrations added to bupivacaine in US-guided bilateral lateral TAP block.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group H1 | Experimental | patients will received TAB block with 19 ml bupivacaine 0.25 % plus 1 ml 0.9% normal saline containing 750 IU hyaluronidase as an adjuvant in each side after closing skin. |
|
| Group H2 | Experimental | patients will received TAB block with 19 ml bupivacaine 0.25 % plus 1 ml 0.9% normal saline containing 1500 IU hyaluronidase as an adjuvant in each side after closing skin. |
|
| Group C | Placebo Comparator | patients will received TAB block with 19 ml bupivacaine 0.25 % plus 1 ml 0.9% normal saline without any adjuvant in each side after closing skin. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hyaluronidase | Drug | hyaluronidase will be applied as adjuvant to bupivacaine in transversus abdominis plane block to enhance the postoperative analgesic effect after CS |
|
| Measure | Description | Time Frame |
|---|---|---|
| the duration of analgesia | the interval between performing the block and the time of the first request for analgesia. | 24 hours postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| the postoperative pain severity | pain was assessed by the visual analog scale (VAS) pain score (range, 0-10; 0, no pain; 10, worst pain) | every 0,2,4,8,12, up to 24 hours postoperative |
| total morphine consumption |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Samar Rafik Amin | Banhā | Qalyubia Governorate | 13511 | Egypt |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| ID | Term |
|---|---|
| D006821 | Hyaluronoglucosaminidase |
| D002045 | Bupivacaine |
| ID | Term |
|---|---|
| D006026 | Glycoside Hydrolases |
| D006867 | Hydrolases |
| D004798 | Enzymes |
| D045762 | Enzymes and Coenzymes |
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| Bupivacaine Injection | Drug | 20ml bupivacaine will be injected without additives in the transversus abdominis plane block on each side for postoperative analgesic after CS |
|
| at 24 hours postoperatively |
| patient satisfaction | assessed on a four-point scale (1, excellent; 2, good; 3, fair; 4, poor) | at 24 hours postoperatively |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D011133 |
| Polysaccharide-Lyases |
| D019757 | Carbon-Oxygen Lyases |
| D008190 | Lyases |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |