Erector Spina Plane Block in Laparoscopic Sleeve Gastrectomy Surgery
|ClinicalTrials.gov Identifier: NCT04039321|
Recruitment Status : Completed
First Posted : July 31, 2019
Last Update Posted : December 23, 2019
|Condition or disease||Intervention/treatment||Phase|
|Obesity||Drug: ESPB group Drug: Control group||Not Applicable|
Optimal pain management is very important in obese patients. In the postoperative period, narcotic analgesics are often used to pain management. However, the use of narcotic analgesics in the postoperative period causes many undesirable adverse effects, especially sedation, dizziness, constipation, nausea, vomiting, muscle rigidity, tolerance, and respiratory depression.
The morbidly obese patients treated with narcotic analgesics increased risk for adverse effects such as atelectasis, hypoxemia, and postoperative ileus. Consequently, these are caused postoperative pulmonary complications, hypoxemia and longer lenght of hospital stay. Multimodal analgesia including local and regional anesthesia is recommended for morbidly obese patients.
In recent years, the ultrasound (USG) guided ESP block has been frequently used to eliminate postoperative pain and reduce narcotic analgesic use. In the literature, it has been shown that bilateral USG guided ESP block provides effective analgesia and decrease the analgesia requirements after laparoscopic cholecystectomy. Some case series and case reports has also been reported that ESP block provides effective analgesia after abdominal and bariatric surgeries.
The aim of the study is to evaluate the effect of erector spina plane (ESP) block on pulmonary functions and postoperative analgesic consumption in patients undergoing bariatric surgery. For this purpose, ASA II-III, patients over 18 years of age, BMI 40-60 kg/m2 and elective bariatric surgery planned patients will be included in the study.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||40 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Single (Care Provider)|
|Official Title:||The Effect of Erector Spina Plane Block on Pulmonary Functions and Analgesic Consumption in Laparoscopic Sleeve Gastrectomy Surgery|
|Actual Study Start Date :||August 1, 2019|
|Actual Primary Completion Date :||December 4, 2019|
|Actual Study Completion Date :||December 4, 2019|
Active Comparator: ESPB group
Before anaesthesia induction; bilateral ESP block will be performed under the guidance of USG. Patients will be administered paracetamol 1 gr IV every 8 hours in the postoperative period. If patients' NRS score will ≥4/10, 100 mg IV tramadol will be performed.
Drug: ESPB group
USG probe will be placed in a longitudinal parasagittal orientation 3 cm lateral to T7 spinous process. The erector spinae muscles will be identified hyperechoic transverse process. The patient's skin will be anesthetized with 2% lidocaine. A 21-gauge 10-cm needle was inserted using an in-plane superior-to-inferior approach or an outplane approach. Following confirmation of the correct position of the needle with 5 ml normal saline, a dose of 20 ml %0.25 bupivacaine will be administered. The same procedure will be performed at the other site (totally 40 ml %0.25 bupivacaine). Standard pain follow up and monitorization will be performed.
Sham Comparator: Control group
Patients will be administered paracetamol 1 gr IV every 8 hours in the postoperative period. If patients' NRS score will ≥4/10, 100 mg IV tramadol will be performed.
Drug: Control group
The patients in this group will be performed no block. Standard pain follow up and monitorization will be performed.
- pulmonary function test [ Time Frame: perioperative ]Pulmonary function test will be performed for all of them in the day before operation and 24 hours after the operation. Pulmonary function tests will assess via a portable spirometer with the patient in the sitting or semi-recumbent position.
- analgesia consumption [ Time Frame: 24 hours ]postoperative 24 hours
- Postoperative Numeric Rating Scale (NRS) score [ Time Frame: postoperative 0, 1, 3, 6, 9, 12, 18, 24 hours ]postoperative pain assessment will be performed using NRS score (NRS 0=no pain, NRS 10= most severe possible). The NRS scores will be recorded at postoperative 0, 1, 3, 6, 9, 12, 18 and 24 hours
- arterial blood gases [ Time Frame: during the surgery ]intraoperative
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04039321
|Antalya Training and Research Hospital, Department of Anesthesiology and Reanimation|
|Antalya, Turkey, 07100|
|Principal Investigator:||Arzu Karaveli||Antalya TRH|