The Effects of Erector Spinae Plane Block on Bariatric Surgery.
Condition: Laparoscopic Bariatric Surgery
Study type: Interventional

Summary: 
      The erector spinae plane block (ESPB) is a new technique that is increasingly used in the
      treatment of acute and chronic pain. Bariatric surgery is a surgical treatment method used in
      the treatment of morbid obesity and related comorbidities. Providing pain control in obese
      patients is a topic that remains up-to-date. Poorly controlled early postoperative pain
      impairs quality of recovery, increases the risk of postoperative pulmonary complications, and
      is a risk factor for the subsequent development of chronic pain. Therefore, optimizing acute
      postoperative analgesia is a priority in patients undergoing bariatric surgery. The primary
      aim of this prospective, randomized study is to evaluate the effect of ESPB on quality of
      recovery with the QoR-40 questionnaire in patients undergoing elective Laparoscopic Bariatric
      Surgery.
    

Detailed description: 
      In the operating room, all patients will receive standard monitoring, including
      electrocardiography, non-invasive blood pressure, and peripheral oxygen saturation. Patients
      in the ESPB group will be placed in a sitting position. A convex probe ultrasound transducer
      will be placed in a longitudinal parasagittal orientation approximately 3 cm lateral to the
      spinous process. The needle tip was advanced until it will be located in the inter-fascial
      plane deep to the erector spinae muscle group and superior to the transverse process. Once in
      position, bupivacaine 0.25%, 20 ml was injected under ultrasound, guidance. The same
      procedure will be repeated on the contralateral site. Standard perioperative and
      postoperative analgesia protocol will be given and postoperative pain levels will be
      determined by Numerical Rating Scale (NRS). NRS scores for pain and postoperative opioid
      consumption will be recorded on the 15th,30th minute, 1st, 2nd, 12th, 24th hour, 2nd day.
      Quality of recovery-40 (QoR-40) scores will be given on the ward, at postoperative 24th hour,
      3rd and 7th day ( the 3rd and 7th-day scores will be calculated after telephone interview if
      the patient will be discharged from the hospital).
    

Intervention name(s): Perioperative and postoperative multimodal analgesia; ESP Block
Intervention type(s): Procedure; Procedure
Intervention description(s): Patients will receive standard multimodal analgesia comprising paracetamol, tenoxicam, and tramadol.
The pain intensity during rest and motion will be evaluated with the 0-10 Numeric Rating Scale (NRS). NRS scores for pain and postoperative opioid consumption will be evaluated at 15th and 30th minutes, 1st, 2nd, 6th, 12th, 24th hours, 2nd day.; Patients in the ESPB group will be placed in a sitting position. A convex probe ultrasound transducer will be placed in a longitudinal parasagittal orientation approximately 3 cm lateral to the spinous process. Local anesthetic (20 ml 0.25% bupivacaine) will be injected bilaterally into the fascial plane on the deep face of the erector spinae muscle. Standard perioperative and postoperative analgesia protocol will be given and postoperative pain levels will be determined by Numerical Rating Scale (NRS). NRS scores for pain and postoperative opioid consumption will be evaluated at 15th and 30th minutes, 1st, 2nd, 6th, 12th, 24th hours, 2nd day.
Other intervention name(s): Global Quality of Recovery-40 score; Standard Pain Follow up; Global Quality of Recovery-40 score; Standard Pain Follow up
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Barıatrıc Surgery.; Erector spinae block; Quality of recovery (QoR-40)