This subject intends to explore the value of intraoperative celiac plexus block in postoperative acute pain management and its promoting effect on patients' rapid recovery during Whipple surgery through a randomized controlled trial.
This study is a single center, randomized, single-blind controlled study. After calculating the sample size, 66 subjects would be randomly assigned to nerve block group (NB group: local anesthetic injection at the target position) and blank control group (GC group: no celiac plexus block) according to the ratio of 1:1, in order to evaluate the effectiveness and safety of celiac plexus block (CPB) as a part of multimodal analgesia for postoperative pain management. Anesthesia protocol: the standard anesthesia protocol for open Whipple surgery in our hospital was adopted. Postoperative analgesia plan: before abdominal closure at the end of operation, The surgeon was instructed to perform a single celiac plexus block (CPB) under direct vision. Ropivacaine was injected into the target nerve in NB group, but no injection in GC group. After the operation, the anesthesiologist used ropivacaine to perform ultrasound-guided abdominal wall nerve block. When leaving the operating room, connect intravenous analgesia pump. Patients with subjective pain score of 3 or above can press. If the analgesia is insufficient, intravenous injection of dezocine can be added temporarily. The intravenous analgesia pump shall be withdrawn after 72 hours of use. If the analgesia pump is used up and is still needed, the anesthesiologist can evaluate and add medicine.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
78
The surgeon is instructed to perform a single celiac plexus block under direct vision. 10ml 0.5% ropivacaine is injected into the nerve in both sides.
Mixed solution for nerve block, made of 0.75% ropivacaine (Naropin, Astrazeneca AB) diluted in different proportions.
Second Affiliated Hospital, School of Medicine, Zhejiang University
Hangzhou, Zhejiang, China
Opioid consumption
Morphine equivalent
Time frame: 72 hours after surgery
Press of the analgesic pump
Daily frequency of pump presses
Time frame: Every 24 hours post-surgery for 72 hours
Time to first flatus
Time frame: 72 hours after surgery
Length of postoperative hospitalization
Time frame: After surgery to before discharge, up to 2 months
White blood cell count
Laboratory tests of white blood cell count (WBC)
Time frame: At the end of surgery and 24 hours post-surgery
C-reactive protein
Laboratory tests of C-reactive protein (CRP)
Time frame: At the end of surgery and 24 hours post-surgery
Erythrocyte sedimentation rate
Laboratory tests of erythrocyte sedimentation rate (ESR)
Time frame: At the end of surgery and 24 hours post-surgery
Interleukin-6
Laboratory tests of interleukin-6 (IL-6)
Time frame: At the end of surgery and 24 hours post-surgery
Procalcitonin
Laboratory tests of procalcitonin (PCT)
Time frame: At the end of surgery and 24 hours post-surgery
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Pain scores
VAS (0 indicates no pain and score 10 indicates the most severe pain)
Time frame: 6, 12, 24, 48, 72 hours after surgery
Cardiac index changes during celiac plexus block
Celiac plexus block (CPB)
Time frame: Before and 5、10、20 minutes after CPB
Systemic vascular resistance index changes during celiac plexus block
Celiac plexus block (CPB)
Time frame: Before and 5、10、20 minutes after CPB
Postoperative mean arterial pressure
Mean arterial pressure (MAP)
Time frame: Every 12 hours post-surgery for 72 hours
Postoperative heart rate
Heart rate (HR)
Time frame: Every 12 hours post-surgery for 72 hours