Tracheal resection and reconstruction (TRR) is the treatment of choice for most patients with tracheal stenosis or tracheal tumors .The postintubation tracheal stenosis is the common indication for (TRR).The immediate postoperative period can be anxiety provoking for some reasons such as requirement to maintain a flexed neck, oxygen mask, and surgical pain which inadequately treated. Bilateral superficial cervical plexus block (BSCPB) is a popular regional anesthesia technique for its feasibility and efficacy. The use of regional anesthesia in combination with general anesthesia may lighten the level of general anesthesia required , provide prolonged postoperative analgesia and reduce the requirements for opioid analgesics Local anesthetic infiltration into the surgical incision can relieve pain at the wound site after surgery, as part of multimodal analgesic approach. Levobupivacaine, is "S"-enantiomer of bupivacaine, has strongly emerged as a safer alternative for regional anesthesia than bupivacaine . Levobupivacaine has been found to be equally efficacious as bupivacaine, but with a superior pharmacokinetic profile. Clinically, levobupivacaine has been observed to be well tolerated in regional anesthesia techniques both after bolus administration and continuous post-operative infusion.
The aim of this study is to evaluate the intra- and postoperative efficacy of local wound infiltration versus bilateral superficial cervical plexus block with levobupivacaine for upper tracheal resection and reconstruction surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
TRIPLE
Patients will receive bilateral superficial cervical plexus block
Patients will receive local wound infiltration
Postoperative pain score
Postoperative pain scores will be assessed using postoperative visual analogue score
Time frame: For 24 hours after surgery
Systolic blood pressure
Time frame: For 4 hours after start of surgery
Diastolic blood pressure
Time frame: For 4 hours after start of surgery
Heart rate
Time frame: For 4 hours after start of surgery
Peripheral oxygen saturation
Time frame: For 4 hours after start of surgery
End-tidal Carbon dioxide tension
Time frame: For 4 hours after start of surgery
Bispectral index
Time frame: For 4 hours after start of surgery
Duration of analgesia
It is defined as time taken for first analgesic request of analgesia from extubation
Time frame: For 24 hours after surgery
Cumulative analgesic consumption
total analgesics used for 24 hrs after surgery
Time frame: For 24 hours after surgery
Cortisol serum
Plasma cortisol assay
Time frame: before induction ,one hour after start of surgery and one hour after end of surgery
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