This study aims to compare the ultrasound-guided bilateral erector spinae plane block (ESPB) and oblique subcostal transverse abdominal plane block (OSTAPB) for postoperative analgesia in colorectal surgery.
Colorectal surgery remains the therapeutic cornerstone for the management of a wide variety of gastrointestinal disorders encompassing malignancies and inflammatory conditions. Oblique subcostal transverse abdominal plane block (OSTAPB) is a regional block technique that involves injecting local anesthetics between the transverse abdominal muscle plane and the internal oblique abdominal muscle plane. Ultrasound-guided erector spinae plane block (ESPB) is a novel technique that specifically targets the ventral rami, dorsal rami, and rami communicantes of the spinal nerves. Local anesthetic agents were observed to extend cranially and caudally over numerous dermatomal levels following injection.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
50
Patients will receive ultrasound-guided erector spinae plane block.
Patients will receive ultrasound-guided oblique subcostal transversus abdominis plane block.
Cairo University
Cairo, Egypt
RECRUITINGDegree of pain
Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS). NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at 0, 2, 4, 6, 12, and 24 h postoperatively.
Time frame: 24 hours postoperatively
Time to the first rescue analgesia
Time to the first request for the rescue analgesia will be recorded from end of surgery to first dose of morphine administrated.
Time frame: 24 hours postoperatively
Intraoperative fentanyl consumption
Additional fentanyl bolus dosages of 1 µg/kg IV will be administered if heart rate or mean arterial blood pressure elevated more than 20% of the baseline (after exclusion of other causes than pain).
Time frame: Intraoperatively
Total morphine consumption
Rescue analgesia of morphine will be given as 3 mg bolus (maximum dose of 0.5 mg/kg/24hours) if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the NRS \< 4.
Time frame: 24 hours postoperatively
Mean arterial pressure
Mean arterial pressure will be recorded at: * T0: Baseline reading preoperatively (in the preoperative holding area). * T1: Immediately before intubation. * T2: 15 minutes after intubation. * T3: 30 minutes after intubation. * T4: 45 minutes after intubation. * T5: 60 minutes after intubation. * T6: At the end of surgery.
Time frame: Till end of surgery (Up to 2 hours)
Heart rate
Heart rate will be recorded at: * T0: Baseline reading preoperatively (in the preoperative holding area). * T1: Immediately before intubation. * T2: 15 minutes after intubation. * T3: 30 minutes after intubation. * T4: 45 minutes after intubation. * T5: 60 minutes after intubation. * T6: At the end of surgery.
Time frame: Till end of surgery (Up to 2 hours)
Degree of patient satisfaction
Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied).
Time frame: 24 hours postoperatively
Quality of Recovery
Quality of Recovery (QOR- 15) scale will be recorded at 24 hours after surgery. Each item on the QoR-15 scale is scored from 0 (unfavourable) to 10 (favourable), resulting in an aggregate score from 0 (no recovery) to 150 (total recovery).
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 will be recorded.
Time frame: 24 hours postoperatively
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