- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03790020
COMPARISON OF TRANSVERSUS ABDOMINIS PLANE BLOCK, LOCAL ANESTHETIC INJECTION TO THE PORT SITES AND INTRAPERITONEAL LOCAL ANESTHESIA APPLICATIONS IN POSTOPERATIVE PAIN MANAGEMENT IN PATIENTS WITH LAPAROSCOPIC APPENDECTOMY (APPENDECTOMY)
March 19, 2021 updated by: ANIL ERGIN, Fatih Sultan Mehmet Training and Research Hospital
The most important determinant of the recovery in abdominal surgery is postoperative pain.
Postoperative pain can be explained by 2 pathways connected to the peritoneum; The first is the parietal peritoneum, whose innervation is very rich and the other is the visceral peritoneum which is stimulated at the vagus level.
Since 1950, they have been injecting local anesthetic for post-surgery pain.
inflammation and peritoneal irritation are the most important factors of pain when acute appendicitis is diagnosed. .
This increases the length of hospital stay and increases the cost of pain relief, and reduces patient satisfaction.
The aim of this study is to evaluate the application of Transversus Abdominis Plane Block .
local anesthetic injection to the port sites, intraperitoneal periappendiceal local anesthetic injection is compared with the control group without any local anesthetic application to investigate which group has more analgesic effectiveness and thus reduce the amount of analgesics needed postoperatively, hospitalization Shortening the duration of the patient and taking the patient comfort to the next level.
Study Overview
Detailed Description
Laparoscopic Appendectomy procedure will be performed in patients over 18 years of age who are hospitalized from the emergency department for acute appendicitis.
4 patient group will be established.
The number of samples determined for Power: 0.80 and alpha: 0.05 was determined as minimum n: 28 for each group.
Therefore, the groups will be determined to include 28 patients.
In our clinic, local anesthetic injection to the trocar areas is routinely performed in laparoscopic appendectomy operations.
After endotracheal intubation at the beginning of the operation, after appropriate skin staining and sterile dressing Transversus abdominis plane block (10 cc / 10 cc, 0.5% bupivacaine to the right and left transversus abdominis muscle regions) will be applied.
local anesthetic injection to the pre-incision trocar sites (8 cc instead of infraumbilical trocar, 6 cc instead of the other 2 trocar 20 cc 0.5% bupivacaine solution will be applied), following intraperitoneal direct visualization of the appendiceal region - local anesthetic spraying into the periappendiceal area(1: 1 diluted with 20 cc saline, 20 cc 0.5% bupivacaine solution total 40 cc spraying ) will be applied.
The fourth group will be the control group and any of these methods will not be applied, operation time and peroperative complications (appendiceal perforation etc.) will be recorded.Paracetamol 1 g + 1 mg / kg tramadol IV will be applied to all four groups as standard before extubation.
Visual analogue scale (VAS) will be applied to all patients in the postoperative period.
If VAS> 3 is still present, a dose of 1 mg / kg tramadol will be administered.
Tenoxicam 1x1 IV will be applied to the patients on the 12th hour.
All patients were postoperative; 1,2,4,6,12,24.
VAS scores , patient satisfaction (0: never satisfied, 5: very satisfied) will be recorded.
The group of patients will be determined according to the order of surgery.
Pain scores of the patients will be performed by a physician who is not in the operation who does not know which group is taken.
The patients included in the group will not be known to the patient by the pain scoring system and the study will be done as double blind.
Patients will be randomized with this method.
Study Type
Interventional
Enrollment (Actual)
3
Phase
- Phase 4
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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-
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Istanbul, Turkey, 34734
- Fatih Sultan Mehmet Research and Training Hospital
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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 70 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patients older than 18 years of age with acute appendicitis in emergency department
Exclusion Criteria:
- Patients who have to undergo peroperative open appendectomy procedure.
- Patients with local anesthetic or non steroid antiinflammatory allergy
- Patients in pregnancy
- Patients with connective tissue disease
- Patients with malignancy detected in pathological examination of postoperative appendix and patients with any malignancy diagnosis
- Perforated patients peroperatively
- Patients who were evaluated as plastron appendicitis peroperatively
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: Supportive Care
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: transversus abdominis plane Block
Transversus abdominis plane block (10 cc / 10 cc, 0.5% bupivacaine to the right and left transversus abdominis muscle regions) will be applied.
|
In our study this local anesthetic agent will be applied for postoperative pain relief
Other Names:
|
Active Comparator: TROCHAR SITES LOCAL ANESTHETIC INJECTION
local anesthetic injection (6 cc to subxiphoid and infraumbilical trocar sites, 4 cc instead of 2 cc, 0.5% bupivacaine solution to be applied)
|
In our study this local anesthetic agent will be applied for postoperative pain relief
Other Names:
|
Active Comparator: INTRAPERİTONEAL LOCAL ANESTHETIC SPREADING METHOD
Intraperitoneal direct vision of the appendix excision area-periappendiciall area under the direct injection of local anesthetic spraying process (percutaneous method injected into the periappendicial area 1: 1 diluted with 20 cc SF, 20 cc 0.5% bupivacaine solution total 40 cc spraying will be applied.
|
In our study this local anesthetic agent will be applied for postoperative pain relief
Other Names:
|
No Intervention: CONTROL GROUP
group will be the control group and any of these methods will not be applied,
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
compare of local anesthetic applying methods for postoperative pain relief by VAS (Visual Analog Scala)
Time Frame: 24 hours
|
pain scores of the participants will be followed at postoperative 1,2,4,6,12,24 hour (up to 24 hours). (VAS: from 0 to 10, 0 = no pain, 10 = the worst pain) The higher score idicates the worse outcome. |
24 hours
|
Collaborators and Investigators
This is where you will find people and organizations involved with this 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)
November 1, 2018
Primary Completion (Actual)
November 1, 2020
Study Completion (Actual)
March 1, 2021
Study Registration Dates
First Submitted
December 15, 2018
First Submitted That Met QC Criteria
December 27, 2018
First Posted (Actual)
December 31, 2018
Study Record Updates
Last Update Posted (Actual)
March 23, 2021
Last Update Submitted That Met QC Criteria
March 19, 2021
Last Verified
March 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- ANIL ERGIN.....
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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