Laparoscopic Guided Peri-wound Transversus Abdominis Plane Block With Bupivacaine Versus Local Wound Infiltration on Post-op Opioid Use in Laparoscopic Sleeve Gastrectomy

Study Overview
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Brief Summary
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The goal of this randomized controlled trial is to compare laparoscopic guided peri-wound Transversus Abdominis Plane Block and bupivacaine versus local wound infiltration effect on reducing post-op opioid use in Laparoscopic Sleeve gastrectomy. The main questions it aims to answer are: • Can laparoscopic guided peri-wound Transversus Abdominis Plane Block reduced post operative morphine usage when comparing with local wound port site infiltration. Participants will be randomize into 2 group peri-wound Transversus Abdominis Plane Block local wound port site infiltration

Official Title
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Comparison of Laparoscopic Guided Peri-wound Transversus Abdominis Plane Block With Bupivacaine Versus Local Wound Infiltration on Post-op Opioid Use in Laparoscopic Sleeve Gastrectomy, A Prospective Randomized Controlled Study

Conditions
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Morbid Obesity, Laparoscopic Sleeve Gastrectomy, Transversus Abdominis Plane Block, Local Wound Infiltration, Bupivacine, Opioid Use

Intervention / Treatment
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* Procedure: peri-wound Transversus Abdominis Plane Block
* Procedure: Local wound infiltration


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patient undergoing LSG at Sringarind hospital as indicated by Thai guideline Exclusion Criteria: Allergic/contraindicated to bupivacaine, morphine, fentanyl, NSAIDs or Nefopam Unable to describe pain score Opioid addict denied consent

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: local wound infiltration<br>0.25% Bupivacaine 20ml was injected into the wound subcutaneous tissue after the laparoscopic port was removed | Procedure: Local wound infiltration<br>* 0.25% bupivacaine 20ml was injected using no24 needle into subcutaneous tissue after the abdominal sheet was sutured.<br>|
| Experimental: peri-wound Transversus Abdominis Plane Block<br>0.25% Bupivacaine 20ml was injected into the transversus abdominis plane around the wound before the laparoscopic port was removed | Procedure: peri-wound Transversus Abdominis Plane Block<br>* 0.25% bupivacaine 20ml was injected using no24 needle into a plane between internal oblique muscle and transversus abdominis muscle around every wound 2 cm. from wound opening. The procedure was confirmed by laparoscopic vision and the injection was done before removal of laparoscopic port.<br>* Other names: TAP block;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cumulative morphine use |  | 48hour after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post op VAS pain score |  | 48hr after intervention | 
| length of hospital stay |  | within admission | 
| opioid side effect |  | within admission | 
| PACU time |  | 1day after intervention | 
| postop complication |  | 2week after intervention |