This study aimed to compare the analgesic effect of bilateral ultrasound-guided modified thoracoabdominal nerve block with bilateral ultrasound-guided erector spinae plane block in abdominoplasty surgery.
Abdominoplasty is an extra-peritoneal surgery devoid of visceroperitoneal component of pain, most of pain is initially related to the abdominal wall's facial plication in addition to pain generated from the abdominal wall incision. Ultrasound guided erector spinae plane block (ESPB) is considered relative an effective block that can be used to provide postoperative analgesia in abdominoplasty (Tulgar et al., 2018). Erector spinae plane block (ESPB) is an interfascial plane block was used to relieve chest neuropathic pain. The modified thoracoabdominal nerve block through the perichondral approach (M-TAPA) is a novel regional nerve block that can provide optimal analgesia for both the lateral and anterior abdominal wall. It can provide wide range of analgesic coverage of the trunk (i.e., T7-T12) by a single puncture per side and has been initially reported to provide a longacting analgesia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
48
Patients received only standard general anesthesia using intravenous propofol (2-3 mg/kg), fentanyl intravenous (1.5µ/kg) and atracurium besylate (0.6 mg/kg).
Patients received modified thoracoabdominal nerve block bilaterally using 25 mL of bupivacaine 0.25% and a lidocaine mixture (15 mL of bupivacaine 0.5% plus 5 mL of 2% lidocaine).
Mansoura University
Al Mansurah, Dakahlia Governorate, Egypt
Total opioid consumption
Intravenous pethidine (0.5mg/kg) was taken every 12 hours as rescue analgesia.
Time frame: 24 hours postoperatively
Duration of analgesia
Duration of analgesia was recorded from the end of surgery till the first dose of pethidine administered.
Time frame: 24 hours postoperatively
Degree of pain
A postoperative numeric rating scale (NRS) was employed to assess patients' postoperative pain levels. It is scored from 0 to 10 (0 meaning no pain and 10 meaning the worst pain). NRS was assessed at 0, 6, 12, and 24 hr postoperative.
Time frame: 24 hours postoperatively
Cortisol level
Cortisol level was recorded at basal, 8 hr, and 24 hr postoperative.
Time frame: 24 hours postoperatively
C-reactive protein (CRP) level
The C-reactive protein (CRP) level was recorded at basal, 8 hr, and 24 hr postoperatively.
Time frame: 24 hours postoperatively
Incidence of complications
Incidence of complications such as nausea, vomiting, pruritus, and respiratory depression were recorded.
Time frame: 24 hours postoperatively
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Patients receive erector spinae plane block bilaterally using 25 mL of bupivacaine 0.25% and a lidocaine mixture (15 mL of bupivacaine 0.5% plus 5 mL of 2% lidocaine).