Clinical trial NCT04941170: U/s Guided Oblique Subcostal Transversus Abdominis Plane Block Versus Erector Spinae Plane Block as Preemptive Analgesia
Official title: U/s Guided Oblique Subcostal Transversus Abdominis Plane Block Versus Erector Spinae Plane Block as Pre-emptive Analgesia for Open Umbilical Hernia Repair; Randomized, Double-blinded Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE4
Conditions: Pain
Hernia, Umbilical
Keywords: Open umbilical hernia
Transversus abdominis plane block
Erector spinae plane block
Lead sponsor: Benha University
Sponsor class: OTHER
First posted: 2021-06-28
Enrollment: 70
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Administration of opioids for the treatment of acute pain after open umbilical hernia repair is associated with many side effects. Erector spinae plane (ESP) block is a novel inter-fascial plane block used in postoperative pain and chronic neuropathic pain relief of the thoracoabdominal region.TAP block is a regional injection of local anaesthetic between the transversus abdominis and internal oblique muscle planes. TAP block affects the sensory nerves of the anterolateral abdominal wall (T6-L1) that innervate the abdomen.

Detailed description: TAP block is a regional injection of local anaesthetic between the transversus abdominis and internal oblique muscle planes. TAP block affects the sensory nerves of the anterolateral abdominal wall (T6-L1) that innervate the abdomen. TAP block is an easy technique and decreases postoperative pain and opioid consumption.

Erector spinae plane (ESP) block is a novel inter-fascial plane block used in postoperative pain and chronic neuropathic pain relief of the thoracoabdominal region. However, its first use was for the treatment of chronic pain, but recently it has been used as a postoperative regional analgesia technique in different surgeries from the shoulder to hip regions (3-4) The present study will be carried out to compare the preemptive analgesic efficacy between the ultrasound-guided bilateral ESP block versus bilateral oblique subcostal TAP block on patients undergoing open umbilical hernia repair.

Eligibility criteria: Inclusion Criteria:

1. American Society of anesthesiologists I-II, scheduled for open umbilical hernia repair.
2. Age range of 18-65 years.

Exclusion Criteria:

1. patient refusal.
2. Patients belonging to ASA grade III and grade IV.
3. Extreme obesity (BMI \>35).
4. hepatic or renal insufficiency.
5. preoperative cognitive dysfunction or communication disorder.
6. allergy to amide-type local anaesthetics.
7. back puncture site infection.
8. Coagulation disorders, pregnancy, drug abusers.

Primary outcomes:
measure: total morphine consumption.
timeFrame: in first 24 hours
Secondary outcomes:
measure: Intraoperative fentanyl consumption
timeFrame: From the start of operation till its end up to 3 hours.
measure: time of first analgesic request
timeFrame: in 24 hours
measure: pain severity evaluation.
timeFrame: at PACU admission , 30 minutes , 2 hours , 4 hours , 8 hours ,12 hours ,18 hours and 24 hours post operative
Other outcomes:
Locations:
city: Banha
country: Egypt
facility: Banha Faculity of Medicine
state: Elqalyoubea
Study officials:
affiliation: Benha University
name: fatma ah abdelfatah, MD
role: PRINCIPAL_INVESTIGATOR
References: