This study aims to evaluate the efficacy of ultrasound-guided external oblique and rectus abdominis plane block on the neuroendocrine stress response and postoperative analgesia in adults undergoing umbilical hernia repair.
Umbilical hernias of the abdomen are defined as a non-inguinal, non-hiatal defect in the fascia of the abdominal wall. Surgical stress response refers to the physiologic response to surgery and the hormonal and metabolic changes that follow it. Fascial plane blocks are gaining attention for perioperative analgesia due to their efficacy and safety profiles. The external oblique and rectus abdominis plane (EXORA) block is an emerging technique that provides a sensory block to the anterolateral abdominal wall, potentially filling gaps left by other commonly used blocks, such as the quadratus lumborum (QLB) or erector spinae plane (ESP) blocks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
100
Patients will receive general anesthesia only.
Patients will receive general anesthesia and an external oblique and rectus abdominis plane (EXORA) block with 0.25% bupivacaine.
Tanta University
Tanta, Egypt
RECRUITINGNeuroendocrine stress response
Neuroendocrine stress response will be measured by blood glucose level in adults undergoing umbilical hernia repair.
Time frame: 24 hours postoperatively
Serum cortisol level
Serum cortisol level will be measured.
Time frame: 24 hours postoperatively
Time of first rescue analgesia
Time of first rescue analgesia will be recorded from the end of surgery till first dose of morphine administration.
Time frame: 24 hours postoperatively
Total intraoperative fentanyl consumption
Rescue dose of intraoperative fentanyl given will be recorded.
Time frame: Intraoperatively
Total morphine consumption
Intravenous morphine (rescue analgesic) at a dosage of 3 mg will be administered when the Numerical Rating Scale (NRS) score will be ≥ 4. The total morphine consumption over a 24-hours period will be recorded for these individuals.
Time frame: 24 hours postoperatively
Degree of pain
Each patient will be instructed in postoperative pain assessment using the Numerical Rating Scale (NRS), ranging from 0 to 10 (0 = "no pain," 10 = "the worst pain imaginable"). NRS will be assessed at post-anesthesia care unit (PACU),1,2,4,6,12,24 hours postoperative
Time frame: 24 hours postoperatively
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