Rectus Abdominis Muscle Parameters and Postoperative Opioid Consumption in Geriatric Patients

N/ANot Yet RecruitingNCT07545824

Istinye University62 enrolled

Overview

This prospective observational study aims to evaluate the relationship between ultrasound-derived rectus abdominis muscle thickness and thickening fraction and postoperative opioid consumption in geriatric patients undergoing abdominal surgery. Preoperative ultrasonographic measurements will be performed during routine clinical care, and postoperative pain scores and analgesic requirements will be recorded within the first 24 hours. The findings may help improve individualized analgesic strategies by identifying patient-specific predictors of postoperative opioid needs.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Postoperative Pain

Interventions

Ultrasound-Guided Rectus Sheath BlockOTHER

Ultrasound-guided rectus sheath block will be performed as part of routine clinical practice in geriatric patients undergoing abdominal surgery. No additional intervention will be introduced for study purposes. Ultrasound-derived rectus abdominis muscle thickness and thickening fraction will be measured preoperatively, and postoperative opioid consumption and pain scores will be recorded within the first 24 hours.

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age ≥65 years * Scheduled for elective midline abdominal surgery * ASA physical status I-III * Planned to receive bilateral ultrasound-guided rectus sheath block as part of routine clinical practice * Provided written informed consent Exclusion Criteria: * Known allergy or hypersensitivity to local anesthetics * Infection or skin lesion at the injection site * Systemic infection or sepsis * Coagulopathy (INR \>1.5 or platelet count \<100,000/mm³) * Use of therapeutic anticoagulation not safely managed perioperatively * History of previous midline laparotomy * History of abdominal mesh implantation or abdominal wall reconstruction * Significant abdominal wall pathology (e.g., large hernia) affecting anatomy * Neuromuscular disease (e.g., myasthenia gravis, ALS, muscular dystrophy) * Inability to perform required maneuver for dynamic ultrasound measurement * Moderate to severe cognitive impairment or poor cooperation * Body mass index (BMI) \>40 kg/m² * Cachexia or severe malnutrition * Chronic opioid use (≥3 months) * Chronic pain syndromes requiring regular analgesic use * Alcohol or substance abuse * Emergency surgery * Use of additional regional anesthesia techniques (e.g., epidural, TAP block) * Inadequate ultrasound visualization of the target anatomical plane

Outcomes

Primary Outcomes

Postoperative Total Opioid Consumption

Total opioid consumption within the first 24 hours after surgery will be recorded and converted to morphine equivalents (mg). This measure will be used to evaluate the association between ultrasound-derived rectus abdominis muscle parameters and postoperative analgesic requirements.

Time frame: First 24 hours postoperatively