Preemptive Analgesic Effects of Rectus Sheath Block in Laparoscopic Cholecystectomy Patients

Study Overview
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Brief Summary
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The purpose of this study was to investigate the effectiveness of preemptive effect of rectus sheath block (RSB) and intercostal nerve block (ICNB) on postoperative visceral pain in laparoscopic cholecystectomy (LLC). After induction of general anesthesia, group of patient is decided randomly. In Group pre, RSB and ICNB are performed with 0.25% Ropivacaine 40ml before the operation. In Group post, RSB and ICNB are performed with 0.25% Ropivacaine 40ml after the operation. Measure the NRS and compare the rescue analgesic dose used at 0, 0.5, 1, 2, 6, 9, 18, and 24 hours after arrival at the recovery room.

Official Title
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The Effectiveness of Preemptive Effect of Rectus Sheath Block and Intercostal Block on Postoperative Visceral Pain in Laparoscopic Cholecystectomy

Conditions
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Acute Pain, Preemptive Peripheral Nerve Block, Pain, Postoperative

Intervention / Treatment
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* Drug: Ultrasound guided Rectus sheath block
* Drug: Intercostal nerve block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adults between the ages of 20 and 80 scheduled laparoscopic cholecystectomy patient ASA class 1 or 2 Patients who have voluntarily agreed in writing to participate in the trial Exclusion Criteria: Patient with side effects on local anesthetics or steroids Patient who are taboo of peripheral nerve block such as blood clotting disorder, infection, etc. Patients with uncontrolled medical or psychiatric problem Patient does not agree to participate in the study Patients who are pregnant or lactating Patients whose visceral pain is expected to be too severe Patients receiving a single laparoscopic cholecystectomy (including using a robot)

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: preoperative Rectus sheath block: group Pre<br>ultrasound guided Rectus sheath block block with 0.25% ropivacaine 40ml Before surgical incision | Drug: Ultrasound guided Rectus sheath block<br>* Ultrasound guided rectus sheath block with 0.25% ropivacaine 34ml around umbilicus<br>Drug: Intercostal nerve block<br>* Ultrasound guided intercostal nerve block with 0.25% ropivacaine 6ml in 7,8,9 th intercostal space<br>|
| Active Comparator: postoperative Rectus sheath block: group Post<br>ultrasound guided Rectus sheath block block with 0.25% ropivacaine 40ml After surgical incision | Drug: Ultrasound guided Rectus sheath block<br>* Ultrasound guided rectus sheath block with 0.25% ropivacaine 34ml around umbilicus<br>Drug: Intercostal nerve block<br>* Ultrasound guided intercostal nerve block with 0.25% ropivacaine 6ml in 7,8,9 th intercostal space<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Difference of analgesic consumption between both group | The difference in analgesics usage between the two groups after the operation is checked at fixed intervals (at 0, 0.5, 1, 2, 6, 9, 18, 24 hours after operation) to compare. | at 0, 0.5, 1, 2, 6, 9, 18, 24 hours after operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| compare the Numeric rating scale (NRS) | The Numeric Rating Scale (NRS-11) is an 11-point scale for patient self-reporting of pain. It is for adults and children 10 years old or older. 0: No pain, 1-3: mild pain, 4-6: Moderate pain, 7-10: severe pain, 10: worst pain imaginable. After surgery, the NRS differences between the two groups were compared at a constant interval (0, 0.5, 1, 2, 6, 9, 18, 24 hours postoperatively). | at 0, 0.5, 1, 2, 6, 9, 18, 24 hours after operation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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preemptive analgic effect, Rectus Sheath Block, laparoscopic cholecystectomy