Clinical trial NCT06144307: Effects of Fascial Plan Blocks on Pulmonary Functions
Official title: Effects of External Oblique Fascial Plan Block and Subcostal Transversus Abdominis Plan Block on Postoperative Pulmonary Functions
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Pain, Postoperative
Respiratory Function Loss
Keywords: postoperative pain
plane block
pulmonary function
Lead sponsor: Zonguldak Bulent Ecevit University
Sponsor class: OTHER
First posted: 2023-11-22
Enrollment: 1
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Patients who will undergo cholecystectomy between the ages of 18-65

Brief summary: In addition to the traumatic effect of the operation, the effort to immobilize the auxiliary respiratory muscles due to pain causes a decrease in postoperative respiratory function (especially in thoracic and upper abdominal surgeries). In addition, superficial and tachypneic breathing caused by the inability of the patient to take deep breaths with pain leads to closure of small airways and increase in intrapulmonary shunts, resulting in hypoxia. Postoperative pain management is important not only to prevent pain but also to reduce pulmonary complications that may occur due to changes in lung function and to reduce mortality and morbidity by controlling the stress response. Pain after nausea and vomiting is the most common reason for hospitalization after laparoscopic surgery.

Although pain in laparoscopic cholecystectomy (LC) has many components including incisional, visceral and reflected, the primary source of pain is incisional pain. A multimodal analgesic approach (NSAII, paracetamol, opioids, local infiltration, facial plane blocks and paravertebral and periparavertebral blocks) is recommended. Regional anesthesia combined with general anesthesia reduces the stress response associated with surgery and reduces the need for opioid use. Subcostal TAP Block; injection of local anesthetic between the internal oblique and transversus abdominis muscles in the upper quadrant of the anterior abdominal wall blocks the anterior cutaneous branches of the thoracoabdominal nerves. External Oblique Fascial Plane Block (EOIB); blocks both the anterior and lateral cutaneous branches of the thoracoabdominal nerves. It is performed between the 6th-7th costae. There is a cutaneous sensory block between T6-T9 in the midabdomen and T6-T10 in the anterior axillary line.

The conventional method is the administration of intravenous opioids as a method of postoperative analgesia when the routine block cannot be performed due to a contraindication.


Eligibility criteria: Inclusion Criteria:

* 18-65 years old
* ASA I-II-III risk group
* Patients whose consent was obtained with an informed consent form
* She will undergo a cholecystectomy operation
* Patients to be cooperative for SFT test

Exclusion Criteria:

* \<18 years and \>65 years
* ASA ≥ IV
* Pulmonary function test below 50% of the expected value
* Known diaphragm paralysis
* Body mass index \>30
* Myocardial infarction within 1 month
* Dementia or confusion
* Lack of cooperation
* People with respiratory diseases
* Congestive heart failure
* Unstable hypertension
* Thoracoabdominal surgery

Primary outcomes:
measure: the effect of plane blocks on postoperative pulmonary function
timeFrame: during the postoperative 24 hours
Secondary outcomes:
measure: opioid consumption
timeFrame: during the postoperative 24 hours
measure: Incidence of nausea and vomiting
timeFrame: during the postoperative 24 hours
measure: quality of recovery-15
timeFrame: during the postoperative 24 hours
Other outcomes:
Locations:
city: Kozlu
country: Turkey
facility: Zonguldak Bülent Ecevit University Faculty of Medicine
state: Zonguldak
Study officials:
References: