Postoperative Pain Relief After Major Abdominal Gynecological Surgery

Çukurova University

Status: Completed

Conditions: Postoperative Pain

Treatments: Procedure: wound infiltration with bupivacaine; Procedure: transversus abdominis plane block with bupivacaine; Procedure: lumbar epidural analgesia with bupivacaine

Study type: Interventional

Funder types: Other

Identifiers

NCT05845385

MAS

Details and patient eligibility

About

The aim of our study was to compare the effects of Lomber Epidural Analgesia (LEA), Transversus Abdominis Plane (TAP) block and Local Anesthetic Infiltration (LAI) on postoperative morphine consumption, time to first recue analgesic request, pain and patient satisfaction scores and side effects were compared in the patients undergoing major gynecologic/oncology lower abdominal surgery.

Full description

Following faculty ethical committee approval and written informed consent, 81 patients were included in our prospective, randomized and double-blind study. Patients were divided into 3 groups: lumbar epidural block (Group E), TAP block (Group T), and wound infiltration (Group I). Demographic data, surgical characteristics, hemodynamic values, pain scores at rest and on movement, morphine consumption, additional analgesic requirement, side effects at 1, 2, 6, 12, 24, 36 and 48th hours after surgery, and patient satisfaction scores at 24 and 48th hours were recorded.

Enrollment: 81 patients

Sex: Female

Ages: 18 to 69 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• ASA I-II,
• between the age of 18-69,
• undergoing major gynecological abdominal surgery under general anesthesia

Exclusion criteria

• lack of patient consent
• ASA > III
• sensitivity or contraindication to study drugs
• conditions in which epidural anesthesia is contraindicated
• emergency and urgent surgery
• inability to comprehend pain scale
• any contraindication to the use of patient controlled analgesia (PCA) device.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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81 participants in 3 patient groups

lumbar epidural analgesia with bupivacaine

Active Comparator group

Description:

For postoperative analgesia; Lumbar epidural catheter inserted at L3-4 or L4-5 epidural space before anesthesia induction in the sitting position. After the end of surgery but approximately 20 minutes before extubation, 0.125% bupivacaine 20 ml administered through epidural catheter and the catheter was removed.

Treatment:

Procedure: lumbar epidural analgesia with bupivacaine

transversus abdominis plane block with bupivacaine

Active Comparator group

Description:

For postoperative analgesia; After the end of surgery but before extubation, USD-guided TAP block was performed with 0.125% bupivacaine 20 ml to the anatomic neurofacial space between the internal oblique and transersus abdominis muscles, bilaterally (10 ml for each side).

Treatment:

Procedure: transversus abdominis plane block with bupivacaine

wound infiltration with bupivacaine

Active Comparator group

Description:

For postoperative analgesia; After the end of surgery but before extubation, 0.125% bupivacaine 20 ml administered to the surgical incision site.

Treatment:

Procedure: wound infiltration with bupivacaine