Rectus Sheath Block: Postoperative Analgesia and Proinflammatory Cytokines

Study Overview
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Brief Summary
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Good quality of postoperative analgesia would lead to attenuate or prevent the adverse effects on the common functions of the immune system. We compared the effect of epidural analgesia versus rectus sheath block on postoperative pain and proinflammatory cytokines following malignant urological surgery.

Detailed Description
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Study groups: 60 patients were included in the study randomly allocated into two groups of 30 patients. Rectus sheath group (RSB): Each patient received bilateral single shot ultrasound guided rectus sheath block under complete aseptic condition in a dose of 30 ml of bupivacaine 0.25% in each side immediately after induction of general anaesthesia. Control group: the patients did not receive any intervention after anaesthesia induction.

Official Title
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Effect of Rectus Sheath Block on Opioid Consumption and Serum Level of TNF-α and IL-6 After Radical Prostatectomy

Conditions
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Postoperative Pain

Intervention / Treatment
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* Drug: Bupivacaine 0.25%


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male patients their age over 40 years, classified ASA I, II or III, undergoing radical resection of cancer prostate, through midline abdominal incision under general anaesthesia. Exclusion criteria: Contraindications to rectus sheath block as patient refusal, coagulopathy, local infection and allergy to bupivacaine. Planned transverse or oblique abdominal incision, extensive existing midline abdominal scarring or pre-existing chronic abdominal pain.

Ages Eligible for Study
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Minimum Age: 40 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: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Rectus Sheath<br>Each patient received bilateral single shot ultrasound guided rectus sheath block under complete aseptic condition in a dose of 30 ml of bupivacaine 0.25% in each side immediately after induction of general anaesthesia | Drug: Bupivacaine 0.25%<br>* Each patient received bilateral single shot ultrasound guided rectus sheath block under complete aseptic condition in a dose of 30 ml of bupivacaine 0.25% in each side immediately after induction of general anaesthesia<br>* Other names: Plain marcaine;|
| No Intervention: Control<br>Control group: the patients did not receive any intervention after anaesthesia induction. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cumulative opioid consumption | study the effect of RSB on cumulative opioid consumption at 24 hours | 24 hours postoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numerical rating scale (NRS) | evaluate postoperative pain intensity by NRS | 24 hours postoperative | 
| time to first anlgesic request | the first time receiving IV-PCA bolus injection | 24 hours postoperative | 
| serum levels of TNF-α | Proinflamatory cytokines | at 24 hours postoperative | 
| Serum level of IL-6 | Proinflamatory cytokines | at 24 hours postoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Rectus sheath block, Postoperative pain,TNF alpha and IL-6