This study is being done to compare 2 types of pain control methods and determine which is more effective postoperatively for laparoscopic colorectal surgery. Group 1 will receive an intrathecal (IT) injection in the back in which a small dose duramorph and bupivacaine will be placed into the spinal fluid. Group 2 will receive an erector spinae plane (ESP) block in which bupivacaine and decadron are injected near the nerves under a muscle in the back.
All laparoscopic colorectal cases were scheduled by colorectal surgeons at IU Health University or Methodist Hospital and were identified using medical records. The subjects were contacted face-to-face prior to surgery. They were informed about the study and questions were answered. The potential subjects were given a copy of the informed consent form and authorization form. The subjects were contacted face-to-face in Pre-Operative Care Unit on the day of surgery and if they decided to participate, written consent was taken. In the Intrathecal group, intrathecal preservative free morphine (duramorph) 200 mcg with 7.5mg of hyperbaric bupivacaine was given for a patient 18-75 years of age and duramorph 150 mcg with 7.5mg of hyperbaric bupivacaine was given for a patient 76- 80 years of age. In the ESP group, a patient was given a bilateral ESP block at thoracic vertebrae level 10 (T10). This was placed under ultrasound using 30 ml of 0.25% bupivacaine and 4 mg of Decadron. Randomization will be performed using Research Randomizer. The primary investigator informed the person doing the regional techniques as to what group the patients were randomized to. Neither the patients and the research staff doing assessments will be blinded to the randomization.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
116
an intrathecal (IT) injection in the back in which a small dose duramorph and bupivacaine will be placed into the spinal fluid
an erector spinae plane (ESP) block in which bupivacaine and decadron are injected near the nerves under a muscle in the back
IU Health University Hospital
Indianapolis, Indiana, United States
24 Hour Cumulated Oral Morphine Equivalent (OME)
24 hour cumulated oral morphine consumption (OME)
Time frame: 24 hours after surgery
Oral Morphine Equivalents (OME)
Oral Morphine Equivalents consumed
Time frame: 1 hour after surgery
Oral Morphine Equivalents (OME)
Oral Morphine Equivalent consumption
Time frame: 12 hours after surgery
Oral Morphine Equivalents (OME)
Oral Morphine Equivalent consumption
Time frame: 24 hours after surgery
Oral Morphine Equivalents (OME)
Oral Morphine Equivalent consumption
Time frame: 48 hours after surgery
Oral Morphine Equivalents (OME)
Oral Morphine Equivalent Consumption
Time frame: 72 hours after surgery
Visual Analog Scale Pain Scores
pain scores using the Visual Analog Scale (0-10 with 0 being no pain and 10 being the worst pain)
Time frame: 1 hour after surgery
Visual Analog Scale Pain Scores
pain scores using the Visual Analog Scale (0-10 with 0 being no pain and 10 being the worst pain)
Time frame: 12 hours after surgery
Visual Analog Scale Pain Scores
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pain scores using the Visual Analog Scale (0-10 with 0 being no pain and 10 being the worst pain)
Time frame: 24 hours after surgery
Visual Analog Scale Pain Scores
pain scores using the Visual Analog Scale (0-10 with 0 being no pain and 10 being the worst pain)
Time frame: 48 hours after surgery
Visual Analog Scale Pain Scores
pain scores using the Visual Analog Scale (0-10 with 0 being no pain and 10 being the worst pain)
Time frame: 72 hours after surgery
First Ambulation
Time to patient first ambulation
Time frame: Duration of hospital stay up to 72 hours
First Flatus
Time to first flatus
Time frame: Duration of hospital stay up to 72 hours
Oral Liquid
Time to first oral liquid intake
Time frame: Duration of hospital stay up to 72 hours
Oral Food
Time to first oral food intake
Time frame: Duration of hospital stay up to 72 hours
Hospital Length of Stay
Amount of time each subject spends in the hospital before discharge
Time frame: Duration of hospital stay up to 7 days
Patient's Satisfaction Scores
Assess patient's satisfaction with care (1-10 with 1 being the least satisfied and 10 being the most satisfied)
Time frame: 24 hours after surgery
Patient's Satisfaction Scores
Assess patient's satisfaction with care (1-10 with 1 being the least satisfied and 10 being the most satisfied)
Time frame: 48 hours after surgery
Number of Participants With Side Effects
Incidence of urinary retention, ileus, spinal headache, pruritis, respiratory depression, injection site infection, nerve damage, hematoma, pneumothorax, lower extremity weakness.
Time frame: Duration of hospital stay up to 72 hours
Nausea
point in time of which had nausea
Time frame: Duration of hospital stay up to 72 hours