Ultrasound Guided- Chemical Rectus Sheath Block for Chronic Pain After Abdominal Midline Incision in Cancer Surgeries
Evaluation of Ultrasound Guided- Chemical Rectus Sheath Block for Chronic Pain After Abdominal Midline Incision in Cancer Surgeries: A Prospective Randomized Controlled Study
The aim of this study is to evaluate peri-operative analgesia efficacy of ultrasound guided transversalis fascia plane block in cancer patients undergoing inguinal lymph node dissection
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Inguinal lymph node dissection is the surgical removal of lymph nodes from your groin (where your legs meet your lower abdomen). Inguinal lymph node dissection is used to see if cancer has spread from certain areas (usually your penis, vulva, anus or the skin on your legs or torso), remove lymph nodes that may be cancerous or have a high chance of becoming cancerous, reduce the risk that cancer will come back in the future and help providers understand the options for treating your cancer and help you know what to expect.
Transversalis fascia plane block (TFPB) used in patients undergoing various surgeries like iliac crest bone harvesting, appendicectomy, cecostomy and inguinal hernia repair, often in combination with TAP block.
The initial description of TFPB was with patients in the supine position, with a linear array or curvilinear probe placed between the iliac crest and the costal margin. The external oblique, internal oblique and transversus abdominis muscles and the transversus aponeurosis are identified.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Ahmed S Abdelgalil, MD
- Phone Number: 00201098426689
- Email: ahmed.salah@nci.cu.edu.eg
Study Locations
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-
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Cairo, Egypt, 12613
- Recruiting
- Cairo University
-
Contact:
- Ahmed S Abdelgalil, MD
- Phone Number: 00201098426689
- Email: ahmed.salah@nci.cu.edu.eg
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- American Society of Anesthesiologists (ASA) class I and II.
- Age ≥ 18 and ≤ 65 Years.
- Cancer patients for inguinal lymph node dissection.
- Body mass index (BMI): > 20 kg/m2 and < 40 kg/m2.
Exclusion Criteria:
- Patient refusal.
- Local infection at the puncture site.
- Coagulopathies with platelet count below 50,000 or an INR>1.6.
- Unstable cardiovascular disease.
- History of psychiatric and cognitive disorders.
- Patients allergic to medication used.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Sham Comparator: Group 1
Patients will receive a sham block was performed using an equivalent volume of normal saline 0.9%. |
Patients will receive a sham block was performed using an equivalent volume of normal saline 0.9%. |
|
Experimental: Group 2
Patients will receive ultrasound guided transversalis fascia plane block. |
Patients will receive ultrasound guided transversalis fascia plane block.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Degree of pain
Time Frame: 24 hours postoperatively
|
Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). |
24 hours postoperatively
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Total fentanyl consumption
Time Frame: Intraoperatively
|
When elevation of Heart rate (HR) or mean arterial blood pressure (MAP) ≥ 20% of the baseline will be treated by fentanyl 0.5 μg / kg. |
Intraoperatively
|
|
Total opioid consumption
Time Frame: 24 hours postoperatively
|
The patients will be observed in the postoperative care unit for 2 h, and rescue analgesia will be provided in the form of intravenous morphine 3 mg with maximum dose of 0.1 mg/kg/dose (max 0.3 mg/kg/day) boluses if the pain score >3. The total amount of morphine given in 24 h will be recorded for every patient. |
24 hours postoperatively
|
|
Mean arterial pressure
Time Frame: 24 hours postoperatively
|
Mean arterial pressure will be recorded before injection of the local anesthetics to be defined as a baseline reading and after injection then will be recorded immediately before and after surgical incision, at 30 min intervals intraoperatively, and immediately postoperative and at 2, 4, 6, 12 and 24 h postoperatively. |
24 hours postoperatively
|
|
Heart rate
Time Frame: 24 hours postoperatively
|
Heart rate will be recorded before injection of the local anesthetics to be defined as a baseline reading and after injection then will be recorded immediately before and after surgical incision, at 30 min intervals intraoperatively, and immediately postoperative and at 2, 4, 6, 12 and 24 h postoperatively. |
24 hours postoperatively
|
|
Incidence of complications
Time Frame: 24 hours postoperatively
|
Incidence of complications such as hemodynamic instability, nausea, vomiting, failed block, unintentional intravascular injection of local anesthesia and local anesthetic toxicity will be recorded |
24 hours postoperatively
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 04-2026-300865
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
IPD Sharing Time Frame
After the end of study for one year.
IPD Sharing Access Criteria
The data will be available upon a reasonable request from the corresponding author.
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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