Evaluation of Postoperative Quality of Recovery Score in Radical Prostatectomy With Erector Spinae Plane Block
Condition: Postoperative Pain
MeSH terms: Pain, Postoperative
Study type: Interventional

Summary: 
      Radical prostatectomy is performed with a median incision below the umbilicus. Although the
      position is supine, the waist extension movement is created in order to facilitate access to
      the surgical site. The investigator think that this may be a factor affecting the
      postoperative comfort, not only in the pain in the surgical field, but especially in patients
      with low back pain (facet joint pain, etc.). Techniques that provide quality postoperative
      recovery with reduced morbidity and rapid return to daily activities are important for
      anesthesiologists.

      In this study, the investigator aimed to evaluate the postoperative recovery quality (Quality
      of Recovery score (QoR-40)) of patients who underwent open radical prostatectomy and
      underwent erector spina plan block and wound infiltration for postoperative analgesia.
    

Detailed description: 
      Patients will be randomly divided into 2 groups as Group E (ESP block) and Group W (Wound
      Infiltration). Before the operation, the ESP block will be applied to the patients in the
      prone position under sedation by same anesthesiologist. Group E (ESP block) will be applied
      bilaterally, 20 ml of %0.25 bupivacaine between the erector spinae muscle and transverse
      process at the 11th thoracic level. Fifteen minutes after the block, the patient's dermotamal
      examination will be evaluated and patients with successful block will be included in the
      study.At the end of the operation,wound infiltration will be administered under general
      anesthesia in supine position by surgeon. Subfascial and subcutaneous wound infiltration is
      performed (20 ml of 0.25% bupivacaine each). 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 IV tramadol patient-controlled analgesia (PCA) device. The solution
      will be prepared such that tramadol is 4 mg / ml. PCA 10 mg bolus dose will be delivered with
      15 min lock-out time. In the postoperative period, the patient was evaluated by another
      researcher who blind to the groups at the 2st and 6th, 12th and 24th hours. Visual pain
      scores (VAS) in rest and movement, hemodynamic values, tramadol consumption, nausea-vomiting
      score, ramsey sedation scale, postoperative complications will be recorded. A 40-item
      recovery of quality of score will be applied in the preoperative and postoperative period to
      evaluate the patient's quality of life.
    

Intervention name(s): Erector Spinae Plane Block; Wound Infiltration
Intervention type(s): Other; Other
Intervention description(s): Group E (ESP block), before the operation, the ESP block will be applied to the patients in the prone position under sedation by same anesthesiologist. ESP block will be applied bilaterally, 20 ml of %0.25 bupivacaine between the erector spinae muscle and transverse process at the 11th thoracic level. All patients will be equipped with an IV tramadol patient-controlled analgesia (PCA) device. In the postoperative period, the patient was evaluated by another researcher who blind to the groups at the 2st and 6th, 12th and 24th hours. Visual pain scores (VAS) in rest and movement, hemodynamic values, tramadol consumption, nausea-vomiting score, ramsey sedation scale, postoperative complications will be recorded. A 40-item recovery of quality of score will be applied in the preoperative and postoperative period to evaluate the patient's quality of life.; Group W, at the end of the operation,wound infiltration will be administered under general anesthesia in supine position by same surgeon. Subfascial and subcutaneous wound infiltration is performed (20 ml of 0.25% bupivacaine each). All patients will be equipped with an IV tramadol patient-controlled analgesia (PCA) device. In the postoperative period, the patient was evaluated by another researcher who blind to the groups at the 2st and 6th, 12th and 24th hours. Visual pain scores (VAS) in rest and movement, hemodynamic values, tramadol consumption, nausea-vomiting score, ramsey sedation scale, postoperative complications will be recorded. A 40-item recovery of quality of score will be applied in the preoperative and postoperative period to evaluate the patient's quality of life.
Other intervention name(s): Group E; Group W
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Group E: Before the operation, the ESP block will be applied to the patients bilaterally, in the prone position under sedation by same anesthesiologist. Group E (ESP block) will be applied 20 ml of %0.25 bupivacaine between the erector spina muscle and transverse process at the 11th thoracic level.
Group W: At the end of the operation,wound infiltration will be administered under general anesthesia in supine position by surgeon. Subfascial and subcutaneous wound infiltration is performed (20 ml of 0.25% bupivacaine each)
In the postoperative period, the patient was evaluated to the groups at the 2st and 6th, 12th and 24th hours. Visual pain scores (VAS) in rest and movement, hemodynamic values, tramadol consumption, nausea-vomiting score, ramsey sedation scale, postoperative complications will be recorded. A 40-item recovery of quality of score will be applied in the preoperative and postoperative period to evaluate the patient's quality of life.
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Erector Spinae Plane Block; Wound Infiltration; Radical Prostatectomy; Postoperative Pain