Triamcinolone Versus Methylprednisolone in Transversus Abdominis Plane Block
Condition: Major Abdominal Surgery
Study type: Interventional
Phase: Phase 2/Phase 3

Summary: 
      In the current Study we will compare between triamcinolone and methylprednisolone as an
      additive to bupivacaine drug in ultrasound guided TAP block in major open abdominal surgery .
    

Detailed description: 
      Postoperative pain is one of the main causes of respiratory function derangement after
      abdominal surgery .Transversus abdominis plane (TAP) block is widely used in abdominal
      surgery for postoperative analgesia The transversus abdominis plane (TAP) block is
      aperipheral nerve block that involves the injection of alocal anesthetic (LA) in the plane
      between the internaloblique and transversus abdominis muscle layers, with the aim of
      anesthetizing the intercostal nerves supplyingthe abdominal wall (from T6 to L1) By blocking
      intercostal nerves T6 to L1, TAPblock efficiently blocks somatic pain after abdominalwall
      surgery

      . It providesadequate postoperative pain relief following various abdominal surgeries TAP
      block can reduce pain scores, opioid consumption, and the incidence of opioid-related
      complications after abdominal surgery.

      The duration of the TAP block is limited to theeffect of the administered LAs. Various
      adjuvantmedications have been added to the LA to prolong theduration of TAP block and magnify
      its effects .

      Perineural injection of steroids is reported to influence postoperative analgesia.

      As a synthetic glucocorticoid, triamcinolone acetonide binds to and activates the
      glucocorticoid receptor to produce anti-inflammatory responses,such as down-regulating
      pro-inflammatory cytokine expression , preventing prostaglandin and leukotriene synthesis and
      release of arachidonic acid, and activating anti-inflammatory transcription factors such as
      lipocortins
    

Intervention name(s): Triamcinolone; Methylprednisolone; bupivacaine
Intervention type(s): Drug; Drug; Drug
Intervention description(s): transversus abdominis plane block with bupivacain and triamicinolone; transversus abdominis plane block with bupivacaine and methylprednisolone; transversus abdominis plane block with bupivacaine alone
Intervention MeSH terms: Methylprednisolone; Methylprednisolone Acetate; Methylprednisolone Hemisuccinate; Prednisolone; Prednisolone acetate; Triamcinolone; Bupivacaine; Prednisolone hemisuccinate; Prednisolone phosphate
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Patient will be evaluated pre operative and full lab will be done In the Pre Anaesthesia Room ,a 20 gauge venous catheter will be inserted in the upper limb , and monitoring included heart rate, electrocardiogram, noninvasiveblood pressure, and peripheral oxygen saturation.Oxygen at the rate of 6 L/min will beadministered through oxygen mask to all patients.
The anesthesiologist who performed the block will be blinded to drug solution and not involved in data collection, another anesthesiologist will prepare drug solution and other anesthesiologist collect the data.
Masking: Double (Participant, Investigator)
Primary purpose: Prevention
Keywords: triamicinolone; methylprednisolone; transversus abdominisus plane block