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the purpose of this study is to compare of better postoperative analgesia following lumber spine discectomy
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| • Control Group | No Intervention | Patients will receive standard analgesia (paracetamol 15mg/kg plus fentanyl 1ug/kg) iv. | |
| (mTLIP )Group | Active Comparator | Patients will receive 20 mL of 0.25% bupivacaine on each side through Modified thoracolumbar interfascial block |
|
| (ESPB) Group | Active Comparator | Patients will receive 20 mL of 0.25% bupivacaine on each side through Erector spinae block |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Regional Anesthetic Injection | Drug | The probe will be placed in the parasagittal plane at the level of the L3 vertebrae. The spinous process will be visualized, and the probe was moved 3 cm laterally from the midline. The erector spinae musclewill be visualized above the transverse process. The needle will be punctured in the craniocaudal direction using the in-plane technique. The needle will be directed superior to the transverse process . Then, 2 mL normal saline solution will be injected into the deep fascia of the erector spinae muscle to confirm the proper injection site. After ensuring the location of the needle, 20 mL of 0.25% bupivacaine will be administered. The same ESPB procedure will be performed on the other side. In total, 40 mL of 0.25% bupivacaine was administered |
| Measure | Description | Time Frame |
|---|---|---|
| Length of hospital stay | from the day of admission till discharge from hospital | up to 1 weak postoperative. |
| Measure | Description | Time Frame |
|---|---|---|
| The recovery time | time from discontinuation of isoflurane to first response to verbal command | up to 30 minutes postoperative. |
| The time of discharge | The time from arrival to the PACU to discharge to the ward |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| faculty of medicine,zagazig university Egypt Ext. 002 K.Howida@yahoo.com | Zagazig | 44519 | Egypt |
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| Label | URL |
|---|---|
| https://pubmed.ncbi.nlm.nih.gov/29318534/ | View source |
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| Regional Anesthetic Injection | Drug | The probe will be placed vertically at the L3 vertebrae level. The spinous process and the interspinous muscles (i.e., multifidus, longissimus, and iliocostalis) will be visualized as the anatomic guide points. The probewill be moved laterally to identify the longissimus and iliocostalis muscles . The needlewill be inserted between the longissimus and iliocostalis in the medial-to-lateral direction using the in-plane technique. After confirming the location of the needle, 20 mL of 0.25% bupivacaine will be administered. The same mTLIP procedure will be performed on the opposite side. In total, 40 mL of 0.25% bupivacaine will be administered |
|
| up to 2 hours postoperative. |
| 6 minutes walk test | involves walking for 6 min on a 30 m walking path and measuring the distance | 24 hours postoperative |
| Functional reach test | quantifies participants' dynamic in-place standing balance control to reach distance. The distance between the starting and maximal forward reach distance beyond the participant's arm length represents the reach distance and is recorded in centimeters | 24 hours postoperative |
| Time up and go test | objective measure of functional disability that can be used to evaluate various activities such as standing, accelerating, walking, decelerating, and turning, which are often limited in patients with lumbar degenerative diseases | 24 hours postoperative |
| Pain intensity | 10-point NRS [(0 = no pain, 10 = worst imaginable pain), 1 - 3: Mild pain (nagging, annoying, slightly interfering with activities of daily living (ADLs), 4 - 6: Moderate pain (significantly interfering with ADLs, 7 - 10: Severe pain (disabling, unable to perform ADLs)] | 30 minutes after the end of the surgery, as well as 3, 6, 12, and 24 hours postoperatively |
| Time to first call analgesia | 24 hours postoperative |
| Total naluphine consumption | 24 hours post-operative |