Ultrasound Guided Subcostal Transversus Abdominis Plane Versus Paravertebral Block in the Laparoscopic Cholecystectomy

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Cholecystitis
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Brief Title

Ultrasound Guided Subcostal Transversus Abdominis Plane Versus Paravertebral Block in the Laparoscopic Cholecystectomy

Official Title

Comparison of the Effects of Perioperative Anesthesia Consumption of Ultrasound Guided Subcostal Transversus Abdominis Plane and Paravertebral Block in Laparoscopic Cholecystectomy

Brief Summary

      The investigators aimed to compare the effects of perioperative anesthesia consumption of
      ultrasound guided subcostal transversus abdominis plane and paravertebral block in
      laparoscopic cholecystectomy.

Detailed Description

      Fifty patients aged 18 - 65 years, American Society of Anesthesiologists (ASA) I-II-III,
      scheduled for laparoscopic cholecystectomy were enrolled into the study. Patients were
      allocated into two groups to receive ultrasound guided subcostal transversus abdominis plane
      block (group T, n=25) or ultrasound guided paravertebral block (group P, n=25). In all
      patients; anesthesia was induced with iv propofol (2 mg.kg-1) and maintained with total
      intravenous anesthesia (TIVA) in a mixture of 50 % nitrous oxide and 50 % oxygen with a total
      gas flow rate of 4 L min-1. Neuromuscular relaxation was induced with iv rocuronium (0.5
      mg.kg-1). Propofol (2 mg / cc, 2-4 mg / kg / h) and remifentanil (13.3 mcg / cc, 1-3 mcg / kg
      / h) combination was used in TIVA. Propofol and remifentanil rates increased or reduced
      according to the patient's hemodynamic response. Prior to start surgery, ultrasound guided
      subcostal transversus abdominis plane or paravertebral block was performed in patients .

      Blood pressure, heart rate and peripheral oxygen saturation,TIVA consumption of 0, 5, 10, 15,
      30, 60 min were recorded for all patients.Before the end of surgery, tramadol was
      administered (2 mg / kg) for all patients.

      All patients were evaluated at postoperative 2th, 4th, 8th, 12th, 24th hours with; operation
      time, heart rate, blood pressure, peripheral oxygen saturation, visual pain scores (VAS),
      analgesic consumption, complications (hypotension, anaphylaxis, hematoma, IV injection,
      intra-abdominal organ injury, pneumothorax ) and patient satisfaction status were recorded.
      In the postoperative period if there is additional analgesic requirements (VAS≥4) tramadol 2
      mg.kg-1 was administered as IV. The first hour is needed analgesia were recorded.

Study Type

Interventional

Primary Outcome

anesthetic and opioid consumption during operation

Secondary Outcome

 postoperative VAS scores

Condition

Cholecystitis

Intervention

USG guided Subcostal TAP block

Study Arms / Comparison Groups

 USG guided Subcostal TAP block
Description:  after preparing the skin, ultrasound probe was placed obliquely on the upper abdominal wall along the subcostal margin near the midline. the rectus abdominis muscles, transversus abdominis muscles and the fascial plane (TAP) between rectus abdominis and transversus abdominis muscles were identified. after identification, the block needle was introduced anteriorly in the plane of the ultrasound beam. the needle was directed the transversus abdominis plane and 10 ml of bupivacaine (Marcaine 0,25 %) and 5 ml of lidocaine (2%) was injected after negative aspiration.

Publications

* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information

Recruitment Status

Procedure

Estimated Enrollment

50

Start Date

September 2014

Completion Date

February 2015

Primary Completion Date

January 2015

Eligibility Criteria

        Inclusion Criteria:

          -  Between 18-65 years of age,

          -  ASA I-II-III

          -  laparoscopic cholecystectomy to be applied

        Exclusion Criteria:

          -  patient refusal

          -  mental and psychiatric disorders,

          -  allergy history of the drug to be used,

          -  kyphoscoliotic anatomical disorder

          -  patients with coagulopathies

Gender

All

Ages

18 Years - 65 Years

Accepts Healthy Volunteers

No

Contacts

ILKE KUPELI, ,

Administrative Informations

NCT ID

NCT02379780

Organization ID

mengücek gazi hospital

Responsible Party

Principal Investigator

Study Sponsor

Cukurova University

Collaborators

 Erzincan University

Study Sponsor

ILKE KUPELI, Principal Investigator, MENGUCEK GAZI TRAINING AND RESEARCH HOSPİTAL

Verification Date

March 2015