The Effect of Bilateral Rectus Sheath and Oblique Subcostal Transversus Abdominis Plane Block on Mechanical Power
Condition: Mechanical Power
Study type: Interventional

Summary: 
      The respiratory system receives mechanical power (MP) throughout time during mechanical
      ventilation. Despite its life-saving benefits, mechanical ventilation can cause
      ventilator-induced lung injury (VILI). Recently, VILI has been linked to mechanical power, or
      the amount of energy the mechanical ventilator sends to the respiratory system in a given
      time. The hunt for lung damage-reducing characteristics, notably after VILI and ARDS (Acute
      respiratory distress syndrome), has increased after Covid-19. Mechanical power must be used
      more to promote lung protection. We examined the effects of bilateral rectus sheath and OSTAP
      (Oblique Subcostal Transversus Abdominis Plane ) block on mechanically powered patients.
    

Detailed description: 
      MP is the energy transmitted over time to the respiratory system during mechanical
      ventilation. Although mechanical ventilation is a life-supporting treatment, it has the
      potential to cause damage to the lung structure in a process referred to as VILI. Recently,
      the degree of VILI has been associated with the amount of energy transmitted to the
      respiratory system by the mechanical ventilator within a specific time frame, which is
      referred to as mechanical power. After the occurrence of Covid-19, the search for parameters
      to reduce lung damage, especially following VILI and ARDS, has become more prominent. In this
      regard, promoting lung protection requires the more widespread use of mechanical power. We
      aimed to investigate the effect of bilateral rectus sheath and OSTAP block applied to
      patients on mechanical power.
    

Intervention name(s): Bilateral Oblique Subcostal Transversus Abdominis Plane Block (OSTAP) will be performed.; Bilateral Rectus Sheath Block (RSB) will be performed.
Intervention type(s): Procedure; Procedure
Intervention description(s): The OSTAP block will be conducted in-plane using a 100mm 22 G needle and a linear probe under ultrasound (USG) guidance. The 20cc block will contain 10cc of 0.5% bupivacaine and 10cc of normal saline. Bilateral OSTAP will be administered with 20cc (10cc per side). To apply the block, position the linear probe parallel to the rib edge immediately below it on the anterior abdominal wall. Visible will be the external, internal, transversus abdominis, and rectus muscle junction. The needle tip will move toward the TAP space (between the internal oblique and transversus abdominis muscles). To ensure medication delivery, the needle tip will be visible in the TAP and the drug will be aspirated negatively. USG will also observe drug distribution at the rectus abdominis muscle-TAP space junction.; When the patient is in the supine position, the ultrasound (USG) linear probe is held in the transverse plane at the level just above the umbilicus, where the posterior rectus sheath is best visualized. Using the in-plane technique with a 100mm 22 G needle under USG guidance, the drug prepared will be administered between the rectus muscle and the posterior rectus sheath. For this block, a volume of 20cc will be prepared, consisting of 10cc of 0.5% bupivacaine and 10cc of normal saline. Bilateral Rectus Sheath Block (RSB) will be applied with a total volume of 20cc, 10cc to each side.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Diagnostic