- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03747406
Erector Spinae Block and Transverse Abdominis Plane Block for Sleeve Gasterectomy
December 23, 2019 updated by: Dalia Ismail
Comparison Between Ultrasound-guided Erector Spinae Block and Transverse Abdominis Plane Block in Obese Patients Undergoing Sleeve Gasterectomy.
assess the efficacy of ultrasound guided erector spinae block to decrease the requirement for analgesics after laparoscopic sleeve gastrectomy and to decrease postoperative pain scores and opioid consumption compared to subcostal transverses abdominis block.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Primary outcomes
• Cumulative opioid consumption during the first 24 h postoperatively. For the purpose of comparison, all opioids administered postoperatively will be converted to IV morphine equivalent doses using standard opioid dosage conversion tables.
Secondary outcome parameters
- Pain assessment by the aid of Visual analogue scale (VAS), which is consisted of a "10 cm" line with one end labeled no pain and other end labeled worst intolerable pain. The patients marked the line at the point that best describing the pain intensity. The preoperative assessment included training of the patients about (VAS) for postoperative pain. The length of the line to the patient's mark will be measured and recorded postoperative after 30 min., 4, 6, 8, and 24 hours.
- Failure rate of the block will be calculated, where the block will be considered a failed block if the patient requires more than two doses of rescue analgesia in the first hour postoperatively.
- Duration of surgery (from skin incision till skin closure) and general anesthesia (from induction of GA till extubation).
- Incidence of complications, such as: Nerve injury, Hematoma formation, LA toxicity, and intravascular injection.
Study Type
Interventional
Enrollment (Actual)
66
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Cairo, Egypt
- Faculty of Medicine - Cairo University
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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 59 years (Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
• Patients from 18 to 59 years.
- BMI > 40 kg/m2
- Genders eligible for study: both.
- ASA I-III.
- No contraindications for application of regional anesthesia as Patient refusal, local anesthetic allergy, local sepsis or infection at puncture site, INR > 1.5 or < 12 hours post LMWH.
Exclusion Criteria:
• Patient refusal.
- Extremes of age.
- ASA IV.
- Increased intracranial pressure.
- Coagulopathy or thrombocytopenia less than 100000/ml.
- Sepsis (increased risk of meningitis).
- Infection at the puncture site.
- Pre-existing neurologic disease.
- History of allergy to local anesthetic.
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
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: ESP group
The patient rolled to his side, the level between T9 and T10 identified using ultrasound.
An 8-14 MHz curved array probe (Siemens ACUSON X300 Ultrasound System) will be applied longitudinal orientation 3 cm lateral midline.
The erector spinae and the psoas muscle will be identified.
A skin wheal will be made using lidocaine 1% at each level and then a 22-gauge, 8 cm Tuohy needle (Perifix Epidural Needle) will be advanced inplane until contact with the transverse process.
The needle will be withdrawn slightly and 30cc of bupivacaine 0.25 % (15ml for each side) will be injected slowly after negative aspiration confirmed.
The same procedure will be repeated in the contralateral side.
|
the level between T9 and T10 will be identified using ultrasound as well as transverse processes depth.
An array probe will be applied longitudinal orientation 3 cm lateral midline.
The erector spinae and the psoas muscle will be identified.
A skin wheal will be made using lidocaine 1% at each level and then a 22-gauge Tuohy needle will be advanced inplane until it made contact with the transverse process.
The needle will be withdrawn slightly and 30cc of bupivacaine 0.25 % (15ml for each side) will be injected slowly after negative aspiration was confirmed.
The same procedure will be repeated in the contralateral side.
|
Experimental: TAP group
The patient in supine position.
Under complete aseptic conditions, a linear array transducer 5-12 MHz (Siemens ACUSON X300 Ultrasound System) will be positioned inferior and parallel to the costal margin in a medio-lateral orientation.
The external oblique, internal oblique and transverse abdominis muscles will be identified immediately lateral to the linea semilunaris.
A a 22-gauge, 8 cm Tuohy needle (Perifix Epidural Needle) will be advanced medially and in-plane to the US beam until the tip lies between the fascia of the internal oblique muscle and the transverse abdominis muscle layers.
30 ml of 0.25 % bupivacaine will be injected in each side and the spread will be observed between the two muscles layers.
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a linear array transducer 5-12 MHz will be positioned inferior and parallel to the costal margin in a medio-lateral orientation.
The external oblique, internal oblique and transverse abdominis muscles will be identified immediately lateral to the linea semilunaris.
A a 22-gauge needle will be advanced medially and in-plane to the US beam until the tip lies between the fascia of the internal oblique muscle and the transverse abdominis muscle layers.
30 ml of 0.25 % bupivacaine will be injected in each side and the spread will be observed between the two muscles layers.
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No Intervention: opioid group
will receive intravenous morphine with general anesthesia and total opioid consumption will be calculated
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Cumulative opioid consumption during the first 24 h postoperatively
Time Frame: 24 hours after surgery
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measure total opioid dose in 24 hours after surgery
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24 hours after surgery
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
pain assessment by Visual Analog Scale
Time Frame: 24 hours after surgery
|
it is a "10 cm" line with one end labeled no pain and other end labeled worst intolerable pain.
The patients marked the line at the point that best describing the pain intensity.
The preoperative assessment included training of the patients about (VAS) for postoperative pain.
The length of the line to the patient's mark will be measured and recorded postoperative after 30 min., 4, 6, 8, and 24 hours.If the VAS level is 5 or more this means failure of analgesio and a dose of rescue analgesia is given
|
24 hours after surgery
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Bassant M Abdelhamid, MD, Cairo University
- Study Director: Dalia Khaled, MD, Cairo University
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)
December 1, 2018
Primary Completion (Actual)
June 1, 2019
Study Completion (Actual)
July 10, 2019
Study Registration Dates
First Submitted
November 14, 2018
First Submitted That Met QC Criteria
November 17, 2018
First Posted (Actual)
November 20, 2018
Study Record Updates
Last Update Posted (Actual)
December 26, 2019
Last Update Submitted That Met QC Criteria
December 23, 2019
Last Verified
December 1, 2019
More Information
Terms related to this study
Other Study ID Numbers
- N-125-2018
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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