Erector Spina Plane Block in Laparoscopic Sleeve Gastrectomy Surgery
Condition: Obesity
MeSH terms: Obesity
Study type: Interventional

Summary: 
      The aim of the study is to evaluate the effect of erector spina plane (ESP) block on
      pulmonary functions and postoperative analgesic consumption in patients undergoing bariatric
      surgery.
    

Detailed description: 
      Optimal pain management is very important in obese patients. In the postoperative period,
      narcotic analgesics are often used to pain management. However, the use of narcotic
      analgesics in the postoperative period causes many undesirable adverse effects, especially
      sedation, dizziness, constipation, nausea, vomiting, muscle rigidity, tolerance, and
      respiratory depression.

      The morbidly obese patients treated with narcotic analgesics increased risk for adverse
      effects such as atelectasis, hypoxemia, and postoperative ileus. Consequently, these are
      caused postoperative pulmonary complications, hypoxemia and longer lenght of hospital stay.
      Multimodal analgesia including local and regional anesthesia is recommended for morbidly
      obese patients.

      In recent years, the ultrasound (USG) guided ESP block has been frequently used to eliminate
      postoperative pain and reduce narcotic analgesic use. In the literature, it has been shown
      that bilateral USG guided ESP block provides effective analgesia and decrease the analgesia
      requirements after laparoscopic cholecystectomy. Some case series and case reports has also
      been reported that ESP block provides effective analgesia after abdominal and bariatric
      surgeries.

      The aim of the study is to evaluate the effect of erector spina plane (ESP) block on
      pulmonary functions and postoperative analgesic consumption in patients undergoing bariatric
      surgery. For this purpose, ASA II-III, patients over 18 years of age, BMI 40-60 kg/m2 and
      elective bariatric surgery planned patients will be included in the study.
    

Intervention name(s): ESPB group; Control group
Intervention type(s): Drug; Drug
Intervention description(s): USG probe will be placed in a longitudinal parasagittal orientation 3 cm lateral to T7 spinous process. The erector spinae muscles will be identified hyperechoic transverse process. The patient's skin will be anesthetized with 2% lidocaine. A 21-gauge 10-cm needle was inserted using an in-plane superior-to-inferior approach or an outplane approach. Following confirmation of the correct position of the needle with 5 ml normal saline, a dose of 20 ml %0.25 bupivacaine will be administered. The same procedure will be performed at the other site (totally 40 ml %0.25 bupivacaine). Standard pain follow up and monitorization will be performed.; The patients in this group will be performed no block. Standard pain follow up and monitorization will be performed.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Care Provider)
Primary purpose: Treatment
Keywords: Erector spina plane block; Laparoscopic sleeve gastrectomy; Obesity; Postoperative pain; Pulmonary functions