This study aims to evaluate the safety and efficacy of combined subcostal and lateral transversus abdominis plane (TAP) for postoperative analgesia versus thoracic epidural anesthesia (TEA) in patients undergoing major abdominal cancer surgery.
Postoperative pain is treated using a variety of techniques. It is possible to deliver opioids intravenously, neuraxially, or both. Thoracic epidural anesthesia (TEA) has long been considered the benchmark for analgesia in major abdominal operations due to its consistent efficacy in pain control and additional benefits such as reduced ileus and improved pulmonary function. Transversus abdominis plane (TAP) blocks can be a critical component of postoperative pain management, and they play a crucial role in Enhanced Recovery After Surgery (ERAS) protocols, as they significantly affect recovery and patient well-being.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
50
Patients will receive an ultrasound-guided combined subcostal and lateral transversus abdominis plane block.
Patients will receive an ultrasound-guided thoracic epidural anesthesia.
Assiut University
Asyut, Egypt
RECRUITINGTotal morphine consumption
Rescue analgesia of morphine will be given as 3 mg bolus if the Visual Analogue Scale (VAS) \> 3 to be repeated after 30 min if pain persists until the VAS \< 4.
Time frame: 24 hours postoperatively
Time to the 1st rescue analgesia
Time to the first request for the rescue analgesia (time from the end of surgery to first dose of morphine administrated).
Time frame: 24 hours postoperatively
Mean arterial pressure
Mean arterial pressure will be recorded before skin incision, one minute after skin incision and then recorded regularly every 10 minutes.
Time frame: Till the end of surgery (Up to 2 hours)
Heart rate
Heart rate will be recorded before skin incision, one minute after skin incision and then recorded regularly every 10 minutes.
Time frame: Till the end of surgery (Up to 2 hours)
Degree of pain
Each patient will be instructed about postoperative pain assessment with the Visual Analogue Scale (VAS). VAS (0 represents "no pain" while 10 represents "the worst pain imaginable"). VAS will be assessed at 0, 4, 6, 8, 12, and 24 h postoperatively.
Time frame: 24 hours postoperatively
Incidence of adverse events
Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, or any other complication.
Time frame: 24 hours postoperatively
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