Subcostal Transversus Abdominis Block Versus Erector Spinae Block in Open Cholecystectomy

Sohag University

Status: Not yet enrolling

Conditions: Post Operative Pain, Acute

Treatments: Drug: Sbcostal transversus Abdominis block and erector spinae block for both groups; Procedure: Erector Spinae Block in patients undergoing open cholecystectomy; Procedure: Subcostal Transversus Abdominis Plane block in patients undergoing open cholecystectomy surgery.

Study type: Interventional

Funder types: Other

Identifiers

NCT06410911

Soh-Med-24-04-01MD

Details and patient eligibility

About

Open cholecystectomy is a surgical procedure involving the removal of the gallbladder through a traditional, open abdominal incision the surgeon makes an incision in the upper abdomen, exposes the gallbladder, and carefully disconnects and removes it. Postoperative pain management is a critical aspect of patient care following cholecytectomy surgery. Inadequate pain control can lead to a cascade of complications, including atelectasis, pneumonia, and delayed mobilization. These complications can prolong hospital stays, increase healthcare costs, and lead to patient dissatisfaction. Regional anesthesia techniques, such as subcostal transversus abdominis plane (TAP) block abd erector spinae block are commonly used to provide effective analgesia after cholecystectomy surgery. These techniques target the nerves that supply the surgical site, providing pain relief without the need for opioids. Opioids are associated with a number of side effects, including nausea, vomiting, constipation, and respiratory depression. Subcostal TAP block is a relatively new technique that has been shown to be effective in providing postoperative analgesia after upper abdominal surgery. This technique involves injecting local anesthetic into the TAP, a fascial plane that lies between the internal oblique and transversus abdominis muscles. The TAP block provides anesthesia to the nerves that supply the abdominal wall, including the subcostal nerves. Erector Spinae Plane Block is a newer technique targeting the dorsal rami of the T7-T12 spinal nerves, potentially offering broader analgesia encompassing the abdominal wall, thorax, and diaphragm. Early studies suggest improved pain control and respiratory function compared to traditional methods.

Enrollment: 100 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Age between 18 and 65 years
• Both sex.
• American Society of Anesthesiologists (ASA) I-II Undergoing elective open cholecystectomy surgery.
• Patients who need at least 24hrs hospital admission.

Exclusion criteria

• Known allergy to local anesthetics
• Coagulopathy or bleeding disorders
• Severe respiratory disease
• Neurological disorders
• Pregnancy

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

100 participants in 2 patient groups

Group A

Active Comparator group

Description:

subcostal transversus abdominis plane block will be performed 50 patients undergoing open cholecystectomy surgery

Treatment:

Procedure: Subcostal Transversus Abdominis Plane block in patients undergoing open cholecystectomy surgery.

Drug: Sbcostal transversus Abdominis block and erector spinae block for both groups

Group B

Active Comparator group

Description:

Ultrasound-guided Erector spinae block will be performed 50 patients undergoing open cholecystectomy surgery

Treatment:

Drug: Sbcostal transversus Abdominis block and erector spinae block for both groups

Procedure: Erector Spinae Block in patients undergoing open cholecystectomy