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Abdominal surgery causes severe postoperative pain due to retraction of the abdominal wall and direct manipulation of visceral organs. It leads to delayed postoperative recovery, increased postoperative morbidity and mortality. Intrathecal morphine, epidural analgesia and patient-controlled intravenous analgesia are used in postoperative pain management of abdominal surgeries. Intrathecal morphine is frequently used in many centers because it provides effective pain control. However; morphine has undesirable effects such as urinary retention, postoperative nausea and vomiting, and respiratory depression. Modified thoracoabdominal nerves block through perichondrial approach is a technique defined by the modification of the thoracoabdominal nerves block through perichondrial approach, in which local anesthetics are delivered only to the underside of the perichondral surface. The primary implication of this study is to compare postoperative pain scores and opioid consumption in patients undergoing major abdominal surgery with intrathecal morphine or modified thoracoabdominal nerves block through perichondrial approach.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Modified Thoracoabdominal Nerve BlockThrough Perichondral Approach and PCA | Active Comparator | Modified Thoracoabdominal Nerve BlockThrough Perichondral Approach and Intravenous Patient Controlled Analgesia |
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| Intrathecal Morphine and Intravenous Patient Controlled Analgesia | Placebo Comparator | Intrathecal Morphine 200 mcg and Intravenous Patient Controlled Analgesia (1 mg/ml morphine, 1 cc bolus, 7 min. locked |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Regional Block Comparison | Procedure | Comparing postoperative pain and opioid consumption in groups |
|
| Measure | Description | Time Frame |
|---|---|---|
| Comparison of postoperative opioid consumption between two groups via Patient Controlled Analgesia (PCA) device | Intravenous patient-controlled analgesia (PCA) is a system of opioid delivery that consists of an infusion pump interfaced with a timing device. Intravenous morphine consumption will be recorded via PCA device, then it will be documented in mg/kg units. | 48 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative pain assessment with Numeric Rating Scale (NRS) | In a Numerical Rating Scale (NRS), patients are asked to choose the number | 48 hours |
| Comparison of the frequency of treatment related complications |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Marmara University School of Medicine | Istanbul | Turkey (Türkiye) |
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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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Bradycardia, hypotension, sedation, respiratory depression, urinary retention, itching, need for rescue analgesics.
| 48 hours |
| Participant satisfaction | Whether the patient is very pleased/ satisfied/ unsatisfied/ complainant with the pain treatment will be recorded. | 48 hours |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |