Bilateral Ultrasound Guided ESP Block Versus TAP Block on Post-operative Analgesia After Total Abdominal Hysterectomy

Zagazig University

Status

Completed

Conditions

Post-operative Analgesia

Treatments

Procedure: 1) Ultrasound guided Erector spinae block

Procedure: Ultrasound guided transversus abdominis plane block

Study type

Interventional

Funder types

Other

Identifiers

NCT03965156

5423

Details and patient eligibility

About

Abdominal hysterectomy is an open surgical procedure associated with considerable post-operative pain. Narcotics are often required during patient recovery but can result in adverse side effects. Transversus abdominis plane block(TAP block) is a regional anesthetic technique that is found to be effective as post-operative analgesia after total abdominal hysterectomy. Recently, erector spinae plane block(ESP)block is found to be safe, and simple regional anesthetic technique that decrease total opioid consumption in patient undergoing breast, or abdominal surgery.
The aim is to compare the efficacy of bilateral erector spinae plane block, and bilateral transversus abdominis plane block on postoperative analgesia in patients after abdominal hysterectomy under general anesthesia, and their need for opioid.

Hypothesis

Null hypothesis (H0): No difference between the analgesic effects of bilateral erector spinae plane block, and bilateral transversus abdominis plane block in patients after abdominal hysterectomy under general anesthesia.
Alternative hypothesis (H1): There are difference between the analgesic effects of bilateral erector spinae plane block, and bilateral transversus abdominis plane block in patients after abdominal hysterectomy under general anesthesia.

Full description

Sample size: Assuming that Mean±SD of reduced pain scores in erector spinae plane block is 4.7±3.7 versus 2.5±1 in transversus abdominis plane block.So, the total sample size is 48 cases (24 in each group) using Open Source Statistics for Public Health (open Epi) with confidence interval 95% and power of test is 80%.

d) Method of sample collection:

Forty eight female patients will be divided into two groups by a computer-generated randomization table:

Group (ES) (n=24): will receive bilateral ultrasound guided erector spinae plane block with each block 20 ml of bupivacaine 0.375% plus 5ug/ml adrenaline (1:200000) at the level of T9.

Group (TA) (n=24): will receive bilateral ultrasound guided transversus abdominis plane block with each block 20 ml of bupivacaine 0.375% plus 5ug/ml adrenaline (1:200000).

Enrollment

48 patients

Sex

Female

Ages

40 to 60 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

Female Patient.
Patient acceptance.
Age (40-60) years old.
American Society of Anaesthesiologist (ASA) I / II
Elective total abdominal hysterectomy under general anesthesia.
patient With Body Mass Index (BMI) (25-35kg/m²)

Exclusion criteria

Patient refusal.
Local infection at site of puncture.
Altered mental status.
History of allergy to study drugs ( bupivacaine, morphine).
Patients with chronic pain.
Patients with severe hepatic or kidney impairment.
Patients having a history of hematological disorders, including coagulation abnormality.