Comparison Between External Oblique Intercostal Plane Block and the Transversus Abdominis Plane Block in Paraumbilical Hernia Repair as Analgesia for Intraoperative and Postoperative Pain.

Assiut University

Status: Not yet enrolling

Conditions: Paraumbilical Hernia

Treatments: Procedure: Transversus abdominis plane (TAP) block; Procedure: External Oblique Intercostal (EOI) block

Study type: Interventional

Funder types: Other

Identifiers

NCT06412406

paraumbilical hernia

Details and patient eligibility

About

AIM OF STUDY:

Comparison between effect of external oblique intercostal plane block and the Oblique subcostal transversus abdominis plane block in paraumbilical hernia repair as analgesia for intraoperative and postoperative pain.

Full description

A paraumbilical hernia is a hole in the connective tissue of the abdominal wall in the midline with close approximation to the umbilicus. If the hole is large enough there can be protrusion of the abdominal contents, including omental fat and/or bowel. These defects are usually congenital and are not noticed until they slowly enlarge over an individual's life time and abdominal contents herniate through the hole creating either pain or a visible lump on the abdominal wall. If abdominal contents get incarcerated (or stuck) in the hole this can cause pain. If the abdominal contents become strangulated by losing their blood supply from pinching or twisting those tissue will die. If it is omental fat this will cause pain and could potentially lead to an infection. If the strangulated contents are bowel then in addition to pain the individual will develop a bowel obstruction. And if the dead bowel is not surgically removed in an emergent fashion the condition could be fatal.

Postoperative pain is the major obstacle for early postoperative ambulation and increases the risk of venous thromboembolism and respiratory complications and prolongs the hospital stay. This pain is routinely managed using opiates, which are associated with several side effects, including excessive sedation and postoperative nausea and vomiting (PONV) which may increase hospital stay durations. Transversus abdominis plane (TAP) block is a regional anesthetic technique that has gradually become an alternative for postoperative pain control during laparoscopic abdominal surgeries. It involves the infusion of local anesthetic into the fascial plane of the abdominal wall.

the subcostal transversus abdominis plane block (TAP) targets the upper abdominal wall.

The EOI block represents an important modification that cover the upper lateral abdominal wall.

Oblique subcostal transversus abdominis plane (OSCTAP) block is an US-guided regional anesthesia technique that anesthetizes the nerves of the lower and upper anterior abdominal wall,specifically from T6 to L1. The OSCTAP has been described that can be performed to provide analgesia for abdominal surgery extending above the umbilicus.

Enrollment: 62 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Age between 18 and 65 years with a body mass index (BMI) of 18-35 kg/m2
2. patients with the American Society of Anesthesiologists (ASA) physical status I/II
3. Patients scheduled for elective paraumbilical hernia

Exclusion criteria

• 1-Known hypersensitivity to the study drugs. 2-Body Mass Index > 40 kg/m2. 3- Inability to accurately describe postoperative pain to investigators. 4-Opioid tolerance or dependence. 5-Preexisting history of chronic pain. 6-History of renal, liver, cardiac, neuropsychiatric disorder problems. 7-Bleeding or coagulation abnormality. 8-Patients who received any analgesic 24 h before surgery 9-Patients who have difficulty understanding the study protocol

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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62 participants in 2 patient groups

Transversus abdominis plane (TAP) block

Active Comparator group

Description:

Group A will include 31 patients to receive TAP block with 20 ml volume on each side (0.25 % bupivacaine)

Treatment:

Procedure: Transversus abdominis plane (TAP) block

External Oblique intercostal (EOI) block

Active Comparator group

Description:

Group B will include 31 patients to receive EOI block with 20 ml volume on each side ( 0.25% bupivacaine)

Treatment:

Procedure: External Oblique Intercostal (EOI) block