Rectus sheath block (RSB) is a kind of anterior abdominal wall block. It has postoperative analgesic effect for abdominal surgery with midline incision. Laparoscopic gynecologic surgery is accompanied by significant postoperative pain and usually IV-PCA is used to manage the pain.The purpose of this study is to investigate the analgesic effect of ultrasound-guided RSB to multi-port laparoscopic gynecologic surgery which has incision site at umbilical area. Patients will randomly assigned to two groups, RSB group and Control group. Each patients will assessed for time to first rescue analgesia, verbal numerical rating pain scores, number of rescue analgesic demands, and postoperatively opioids use by IV-PCA by a blinded investigator at 0, 1, 6, 12, 24 and 48 hours postoperatively.
Patients of RSB group will be performed ultrasound-guided bilateral RSB after induction of general anesthesia. The procedure will be performed bilaterally and 15 ml on each side, total 30 ml of 0.25% ropivacaine will be injected. After the procedure, a surgery scheduled will be proceeded. Patient of Control group will be proceeded the surgery after induction of anesthesia. All patients will use total 100 ml of IV-PCA containing 800 µg of fentanyl with 150 mg of ketorolac for 48 hours postoperatively. If a patient complains pain more intense than VNRS 4 or demands an analgesic drug, a rescue analgesic would be allowed.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
Ultrasound-guided bilateral rectus sheath block of RSB group using 0.25% Ropivacaine
Ultrasound-guided bilateral rectus sheath block of RSB group using 0.25% Ropivacaine
After the surgery, a bandage will be attached on injection site where is same as the incision site of surgery.
All patients will use total 100 ml of IV-PCA containing 800 µg of fentanyl and 150 mg of ketorolac for 48 hours postoperatively.
Ewha Womans University Mokdong Hospital
Seoul, South Korea
Number of rescue analgesics
Number of injected additional NSAIDs other than IV-PCA for 48 hours postoperatively
Time frame: 48 hours postoperatively
Total opioids use
Total dosage of injected fentanyl through IV-PCA
Time frame: Time Frame: 0, 1, 6, 12, 24, 48 hours postoperatively
Time to first rescue analgesic request
How long it takes postoperative time to first additional analgesic drug injection by patient's request
Time frame: 48 hours postoperatively
Postoperative pain measured on the verbal numerical rating scale
Postoperative pain on each time point which is expressed by verbal numerical rating scale (0 \~ 10)
Time frame: 0, 1, 6, 12, 24, 48 hours postoperatively
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