Analgesic Efficacy of Transversus Abdominis Plane Block Versus External Oblique Block in Patients Undergoing Elective Laparoscopic Cholecystectomy

Assiut University

Status: Not yet enrolling

Conditions: Laparoscopic Cholecystectomy; Transversus Abdominis Plane Block; External Oblique Block

Treatments: Procedure: drug injected between the rectus abdominis muscle and the transversus abdominis muscle; Procedure: drug injected in the external oblique intercostal plane on both sides

Study type: Interventional

Funder types: Other

Identifiers

NCT06707324

04-2024-201012

Details and patient eligibility

About

Postoperative pain management is a critical aspect of recovery following laparoscopic cholecystectomy, a commonly performed procedure for symptomatic gallbladder disease. Effective analgesia not only enhances patient comfort but also facilitates early mobilization, reduces the incidence of complications, and improves overall outcomes.

Oblique subcostal transversus abdominis plane block (OSTAP), one of the regional anesthesia techniques, is used in middle and upper abdominal surgeries OSTAP blocks the T6-9 intercostal nerves between the rectus abdominis and transversus abdominis muscle. Many studies have shown that OSTAP block reduces the postoperative analgesic and opioid requirement and improves the quality of postoperative pain control.

Full description

the potential mechanism of the external oblique intercostal fascial plane block (EOIB) in a cadaver study in which both lateral and anterior branches of the intercostal nerves T7-T10 were stained. Patients to whom this block was applied exhibited consistent dermatomal sensory blockade between T6-T10 in the anterior axillary line and T6-T9 in the midline. It has been shown that this block can be used in the clinical setting for upper abdominal wall analgesia.

Various adjuvants have been used to improve the quality and increase the duration of the local anesthetic action in different peripheral nerves and regional block techniques. dexamethasone microspheres have increased the block duration in both human and animal studies. Furthermore, dexamethasone has been shown to possess antiinflamatory action.

Enrollment: 50 estimated patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Adult patients aged 18-60 years.
2. Gender: Both males and females.
3. BMI less than 35 kg/m2
4. Scheduled for laparoscopic cholecystectomy surgery
5. American Society of Anesthesiologists - ASA - I & II

Exclusion criteria

1-ASA physical status more than II. 2-History of allergic response to local anaesthetics or any of the medications used in the study

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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50 participants in 2 patient groups

TAB group

Active Comparator group

Description:

20 ml of 0.25% bupivacaine + 8 mg dexamethasone between the rectus abdominis muscle and the transversus abdominis muscle on both sides

Treatment:

Procedure: drug injected between the rectus abdominis muscle and the transversus abdominis muscle

EOB group

Active Comparator group

Description:

20 ml of 0.25% bupivacaine+ 8 mg dexamethasone into the external oblique intercostal plane on both sides

Treatment:

Procedure: drug injected in the external oblique intercostal plane on both sides