To explore and compare Ultrasound-Guided Transversus Abdominis Plane Block on Postoperative nausea and vomiting and Early Outcome After Laparoscopic Bariatric Surgery To evaluate and examine TAPB can reduce the application of intraoperative and postoperative opioids and the duration of analgesia
Poor postoperative nausea and vomiting control is a leading factor that hinders the physical rehabilitation, and causes acute cognitive impairment and chronic pain syndrome. Recently, the multimodal analgesia strategies to minimise opioid-related side effects are highly desirable in open surgical procedures. The transversus abdominis plane block is a novel technique involving injection of local anaesthetic between the internal oblique and the transversus abdominis muscles of the abdominal wall. Although ropivacaine is most commonly used for this technique, the analgesic duration remains not dissatisfied. Herein, investigators will evaluate the efficacy of ultrasound-guided transversus abdominis plane(USG- TAP) block with ropivacaine in Laparoscopic Bariatric Surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
90
Before the induction of anesthesia, normal saline is used for bilateral transversus abdominis plane block in a volume of 20 mL of each side
Before the induction of anesthesia,0.375% ropivacaine is used for bilateral transversus abdominis plane block in a volume of 20 mL of each side
Before the induction of anesthesia, 0.375% Ropivacaine and 5.0mg dexamethasone are used for bilateral transversus abdominis plane block in a volume of 20 mL of each side
Postoperative nausea and vomiting
The Apfel score was recorded for evaluating risk for developing postoperative nausea and vomiting (PONV).
Time frame: 72 hours after surgery
cumulative Sufentanyl Consumption during surgery
Each patient was administered sufentanil for analgesic during surgery
Time frame: during surgery
cumulative Sufentanyl Consumption after surgery
Each patient was administered analgesics using a PCA pump containing sufentanil (100μg) in normal saline at a totalvolume of 100 ml after leaving PACU. This device was set to deliver a basal infusion of 2 ml/h and bolus doses of 0.5ml with a 15-min lockout period. Sufentanyl cumulative consumption is recorded 24 hours postoperative
Time frame: 48 hours after surgery
Time of First Postoperative Analgesic Requiremen
First postoperative pain (NRS≥5) is initially controlled by titration of sufentany
Time frame: 1hour after surgery
Total Dose of First Postoperative Analgesic Requirement
First postoperative pain (NRS≥5) is initially controlled by titration of sufentanyl.
Time frame: 1hour after surgery
The incidence of Side Effects
The number of patients with side effects including nausea, vomiting, dizziness, headache, shivering, and pruritus is recorded for 48 hours postoperatively
Time frame: 48 hours after surgery
Apfel score
The Apfel score was recorded for evaluating risk for developing postoperative nausea and vomiting (PONV).
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Time frame: The 1 day before the surgery
Time to ambulation
The obesity's time to ambulation after surge
Time frame: 12 hours after surgery
Mean time until passage of flatus
Gastrointestinal motility was evaluated by recording mean time until passage of flatus
Time frame: 72 hours after surgery
Diffusion area of local anesthetics after transversus abdominis plane block
Diffusion area of local anesthetics after transversus abdominis plane block was calculated under ultrasound assistance.
Time frame: 30 minutes after transversus abdominis plane block
Normalized Area of Hyperalgesia Around the Incision
The skin around the incision is stimulated in steps of 5 mm at intervals of 1 s starting outside of the hyperalgesic area in the direction of the incision. The distance from the incision to the first point where a 'painful', 'sore' or 'sharper'feeling occurred is measured and noted. This measurement is repeated at predefined radial lines around the incision. To eliminate the variable length of incision, this length is subtracted from the longer diameter leaving four radial distances from the end and from the middle of the incision. The normalized area of hyperalgesia is calculated by summing up the areas of the remaining four triangles measured by and Von Frey filament.
Time frame: 48 hours after surgery