this aim of this study is to compare the analgesic effect of Erector spinae plane (ESP) block and lateral transversus abdominis plan (TAP) block in patients undergoing open appendectomy.
regional technique according to randomization will be given after induction of general anesthesia Fentanyl boluses of 1 mcg/kg will be given in case of inadequate analgesia. Inadequate analgesia identified by 20% increase in the heart rate and/or systolic blood pressure from baseline measurement. postoperative analgesia: regular paracetamol 1 g/6 hours (intravenously at first then orally once the oral feeding is resumed) and 75 mg diclofenac (intramuscularly at first then orally once the oral feeding is resumed). If Numeric rating scale (NRS) is \> 3 intravenous titration of 2 mg morphine is given slowly to be repeated after 30 minutes if pain persisted
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
68
Patients will receive the ESP block at the level of the 10th thoracic (T10) transverse process using a linear 6-13 MHz ultrasound transducer. A 20 mL of 0.25% bupivacaine will be injected below the muscle
Patient will received TAP block using the lateral approach while in supine position. A 20 mL of 0.25% bupivacaine will be injected after negative aspiration.
Cairo University
Cairo, Cairo Governorate, Egypt
RECRUITINGTotal morphine consumption
mg
Time frame: from extubation until 24 hours postoperative
numeric rating scale
a scale of 0-10, where 0 means "no pain" and 10 means "worst imaginable pain"
Time frame: AT 0.5, 2, 6, 12, and 24 hours postoperative.
quality of recovery
assessed using Quality of recovery-15 (QOR-15); Consists of 15 items evaluating five dimensions of health: physical comfort, physical independence, psychological support, emotional state, and pain. Scoring Range: Each item is rated on an 11-point numerical scale (0 to 10). The total score ranges from 0 (extremely poor recovery) to 150 (excellent recovery).
Time frame: 24 hours after suregry
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