Analgesic Effect of Morphine Added to Transverses Abdominis Plane Block
Condition: Pain, Postoperative; Postoperative Complications
MeSH terms: Pain, Postoperative; Postoperative Complications
Study type: Interventional

Summary: 
      Postoperative pain is a condition that increases morbidity and mortality. Therefore,
      multimodal analgesia techniques with fascial plan blocks are frequently used.TAP block
      provides analgesia in the anterior abdominal wall by applying local anesthetic to the fascia
      between the internal oblique and transversus abdominis muscle. Opioids can be added to local
      anesthetics to increase the quality and duration of analgesia. The investigators aim is
      comparasion of TAP block with bupivacaine added morphine and TAP block with bupivacaine plus
      intramuscular morphine effects on postoperative pain score, total opioid consumption and
      systemic effects in lower abdominal surgery
    

Detailed description: 
      At the end of the operation, patients will be randomly divided into 2 groups as Group I
      (Intramuskuler) and Group T (TAP block). The blocks will be administered under general
      anesthesia in supine position by same anesthesiologist. Group I (Intramuskuler) will be
      applied 20 ml of %0.25 bupivacaine between the internal oblique and transversus abdominis
      muscle and 0.1 mg/kg (ideal body weight) morphine to be performed intramuscular. Group T will
      be applied 20 ml of %0.25 bupivacaine and 0.1 mg/kg morphine (ideal body weight) between the
      internal oblique and transversus abdominis muscle. At the end of the operation, the patients
      with a Modified aldreate score ≥9 will be sent from the postoperative anesthesia unit. All
      patients will be equipped with an IV morphine patient-controlled analgesia (PCA) device. The
      solution will be prepared such that morphine is 0.5 mg / ml. PCA 1mg bolus dose will be
      delivered with 10 min lock-out time. In the postoperative period, the patient was evaluated
      by another researcher who blind to the groups at the 1st and 6th, 12th and 24th hours. Visual
      pain scores (VAS) in rest and movement, hemodynamic values, morphine consumption,
      nausea-vomiting score, itching, ramsey sedation scale, length of hospital stay and
      postoperative complications will be recorded.
    

Intervention name(s): Group ıntramuscular; Group TAP
Intervention type(s): Procedure; Procedure
Intervention description(s): Group I will be applied 20 ml of % 0.25 bupivacain internal oblique and transversus abdominis muscle and 0.1 mg/kg morphine ıntramuscular. The blocks will be administered under general anesthesia in supine position by the same anesthesiologist.; Group T will be applied 20 ml of % 0.25 bupivacain and 0.1 mg/kg morphine internal oblique and transversus abdominis muscle. The blocks will be administered under general anesthesia in supine position by the same anesthesiologist.
Other intervention name(s): Fascial plane block and ıntramuscular morphine at lower abdominal surgery; Fascial plane block with morphine at lower abdominal surgery
Intervention MeSH terms: Morphine
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Group I: TAP block with bupivacain and morphine intramuscular will be applied at the end of the operation. Patients will receive paracetamol 1gr 30 minutes before the end of the operation. All patients will undergo IV morphine patient-controlled analgesia (PCA). Pain, opioid consumption, hemodynamic parameters and complications will be monitored in the first 24 hours in the postoperative period.
Group T: TAP block with bupivacain and morphine will be applied at the end of the operation. Patients will receive paracetamol 1gr 30 minutes before the end of the operation. All patients will undergo IV morphine patient-controlled analgesia (PCA). Pain, opioid consumption, hemodynamic parameters and complications will be monitored in the first 24 hours in the postoperative period.
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Other
Keywords: postoperative pain; transversus abdominis plane block; morphine