The Effect of Upper Transabdominal Plain Block on Diaphragm Thickness

March 19, 2023 updated by: Yasin Tire, MD, Konya City Hospital

The Effect of Upper Transabdominal Plain Block on Diaphragm Thickness in Adult Patients After Laparoscopic Cholecystectomy Operation

In the study, patients of both sexes between the ages of 18 and 60 who will undergo laparoscopic cholecystectomy will be examined. In this patient group, the change in the inspiratory and expiratory diaphragmatic thickness before and after laparoscopic cholecystectomy operation in the upper transabdominal block group will be examined.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The use of ultrasonography (USG) in operating rooms is increasing day by day. Diaphragm thickness can be evaluated by ultrasonography and is used as a bedside method studies have proven that the evaluation of diaphragmatic thickness contributes to the observation of diaphragmatic function and the evaluation of respiratory workload. Measurement of diaphragmatic thickness is a method used in operating rooms and intensive care units to make the decision to wean from mechanical ventilation and extubation. Laparoscopic gallbladder operations are a very common operation in the adult age group in the operating room. In these cases who were intubated and extubated at the end of the operation, regression in respiratory function is observed, especially due to right upper quadrant pain appropriate to the location of the liver. For this reason, the respiratory functions of patients who will have gallbladder surgery will be routinely evaluated before and after gallbladder surgery in our clinic with the help of USG and routinely apply analgesic methods, including peripheral nerve blocks, to patients with pain.

In this study, it will be planned to observe the effect of upper transabdominal area block, which is routinely performed post-operatively in laparoscopic gallbladder operations, on diaphragmatic thickness and therefore on respiratory capacity, and observationally evaluating diaphragmatic thickness measurements by USG, which is routinely performed post-operatively and the measurement records are noted.

Study Type

Observational

Enrollment (Actual)

67

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

    • Meram
      • Konya, Meram, Turkey, 42140
        • Yasin Tire

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 60 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

With the calculated sample size values, we will need to include at least 68 patients in our study at 0.5 sensitivity and 0.95 power.

Description

Inclusion Criteria:

  • Patients between the ages of 18-60
  • Both sexes
  • Patiets are evaluated as ASA 1 and ASA 2 anesthesia risk, will be examined.

Exclusion Criteria:

  • Under 18 years old, over 60 years old
  • BMI>35 kg/m2
  • Bleeding diathesis
  • Local anesthetic allergy
  • Infection in the area of TAP (Trans abdominal plane) block application
  • Illiteracy, communication problem
  • Previous upper abdomen operation
  • Transition to open surgery Cases
  • Severe chronic respiratory disease
  • Neuromuscular disorders.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Case-Control
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Upper Transabdominal Plain Block
All patients in this group are routinely administered general anesthesia. After extubation, the subcostal transverse abdominis area block was directed laterally along the rectus abdominis muscle by finding the linea alba under the xiphoid region under ultrasound guidance with a 22G echogenic block needle, and 20 ml (8 ml 0.5% bupivacaine, 7 ml prilocaine) into the fascia between the rectus abdominis and transverse abdominis muscles. , 5 ml of saline) drug mixture will be performed by the anesthesiologist in charge of that day, who is not aware of the observational measurement to be made, if there is an indication, as a blind practitioner.
In the patient group who will undergo elective laparoscopic cholecystectomy, the diaphragmatic thickness values measured and recorded routinely at the pre-operative, post-extubation and post-operative 30th minute, at the end of inspiration and expiration, and the inspiratory amplitude in m-mode in the ultrasound measured from the right anterior axillary line subcostal area were observed as observational data. will be saved in our file.
Opioid analgesia
All patients in this group are routinely administered general anesthesia. Apart from this, in the other group, which does not have peripheral nerve block and only routine opioid analgesia is considered sufficient, only routine peroperative USG diaphragm measurements will be recorded observationally.
In the patient group who will undergo elective laparoscopic cholecystectomy, the diaphragmatic thickness values measured and recorded routinely at the pre-operative, post-extubation and post-operative 30th minute, at the end of inspiration and expiration, and the inspiratory amplitude in m-mode in the ultrasound measured from the right anterior axillary line subcostal area were observed as observational data. will be saved in our file.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Diaphragm Thickness
Time Frame: 5 minutes before general anesthesia
The measurement of Diaphragm Thickness by USG
5 minutes before general anesthesia
Diaphragm Thickness
Time Frame: 5 minutes after surgery
The measurement of Diaphragm Thickness by USG
5 minutes after surgery
Diaphragm Thickness
Time Frame: 5 minutes after upper abdominal plane block
The measurement of Diaphragm Thickness by USG
5 minutes after upper abdominal plane block

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Oxygen saturation
Time Frame: Before the anesthesia, after anesthesia and after 30 minutes in the post operative care unit.
Oxygen saturation separately for each primary outcome stage
Before the anesthesia, after anesthesia and after 30 minutes in the post operative care unit.
Visual analogue scale
Time Frame: Before the anesthesia, after anesthesia and after 30 minutes in the post operative care unit.
The patient's pain will be asked in a scale from 1 to 10.
Before the anesthesia, after anesthesia and after 30 minutes in the post operative care unit.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Study Director: Yasin Tire, Konya City Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 2, 2022

Primary Completion (Actual)

September 1, 2022

Study Completion (Actual)

March 18, 2023

Study Registration Dates

First Submitted

July 25, 2021

First Submitted That Met QC Criteria

August 5, 2021

First Posted (Actual)

August 9, 2021

Study Record Updates

Last Update Posted (Actual)

March 21, 2023

Last Update Submitted That Met QC Criteria

March 19, 2023

Last Verified

March 1, 2023

More Information

Terms related to this study

Other Study ID Numbers

  • KonyaCityH

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

I plan to make individual participant data (IPD) available to only responsible researchers.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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