Ultrasound-guided Erector Spinae Plane Block Versus Paravertebral Block for Perioperative Analgesia in Patients Undergoing Open Splenectomy
Primary Purpose
Analgesia
Status
Completed
Phase
Phase 3
Locations
Egypt
Study Type
Interventional
Intervention
ultrasound guided erector spinae plane block
ultrasound guided paravertebral block
conventional analgesia
Sponsored by
About this trial
This is an interventional treatment trial for Analgesia
Eligibility Criteria
Inclusion Criteria:
- patients who will be scheduled for indicated open splenectomy surgery in the supine position via left subcostal ,midline or letf subcostal with midline extention incisions
- physical status American Society of Anesthesiologists (ASA) II or III.
Exclusion Criteria:
- Patients who refuse to participate
- patients with body mass index (BMI) >35 kg/m2
- infection at the site of injection
- coagulopathy, severe thrombocytopenia <50×103
- spine deformity
- history of opioid dependence
- polytrauma patients with dorsal spine fracture
- urgent abdominal exploration for splenectomy in heamodynamically unstable patients
- history of allergy to opioids or local anesthetics
- history of allergy to opioids, or local anaesthetics.
Sites / Locations
- Ain Shams University hospitals
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Active Comparator
Active Comparator
Active Comparator
Arm Label
general anesthesia+ bilateral US guided erector spinae plane block
general anesthesia+ bilateral US guided paravertebral block
general anesthesia
Arm Description
General anesthesia plus ultrasound guided erector spinae plane block with 20 ml bupivacaine 0.2% at T9
General anesthesia plus bilateral US guided paravertebral block with 7 ml bupivacaine 0.2% at T8 and T10
general anesthesia plus conventional analgesia
Outcomes
Primary Outcome Measures
First time to analgesic requirement
all patients received an IV -PCA system (Accufuser M8P, 60 mL; Woo Young Meditech Co, S.Korea). PCA was prepared with 60 mL of isotonic saline containing 60 mg morphine, and the selected system was adjusted to infuse a 1 mL bolus dose with a lockout interval of 15 minutes while the basal flow rate was switched off. Breakthrough pain was managed with 2mg morphine.
Secondary Outcome Measures
total analgesic consumption
The total dose of rescue analgesics(morphine) required in 24 hours will be recorded.
Numerical rating scale (NRS)
All patients will be monitored in the postoperative period for pain by the NRS score at rest and movement at immediate postoperative (0 min), 30 min, 1, 2, 6,12, and 24 hours.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05448469
Brief Title
Ultrasound-guided Erector Spinae Plane Block Versus Paravertebral Block for Perioperative Analgesia in Patients Undergoing Open Splenectomy
Official Title
Ultrasound-guided Erector Spinae Plane Block Versus Paravertebral Block for Perioperative Analgesia, a Randomized Double Blinded Controlled Trial
Study Type
Interventional
2. Study Status
Record Verification Date
December 2022
Overall Recruitment Status
Completed
Study Start Date
July 10, 2022 (Actual)
Primary Completion Date
December 10, 2022 (Actual)
Study Completion Date
December 10, 2022 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Ain Shams University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
There are very few randomized controlled trials in open splenectomy surgery, which compare paravertebral block with ESP block. The purpose of this randomized controlled trial is to compare the efficacy of ultrasound-guided paravertebral block with ESP block for perioperative analgesia in open splenectomy .
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Analgesia
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
99 (Actual)
8. Arms, Groups, and Interventions
Arm Title
general anesthesia+ bilateral US guided erector spinae plane block
Arm Type
Active Comparator
Arm Description
General anesthesia plus ultrasound guided erector spinae plane block with 20 ml bupivacaine 0.2% at T9
Arm Title
general anesthesia+ bilateral US guided paravertebral block
Arm Type
Active Comparator
Arm Description
General anesthesia plus bilateral US guided paravertebral block with 7 ml bupivacaine 0.2% at T8 and T10
Arm Title
general anesthesia
Arm Type
Active Comparator
Arm Description
general anesthesia plus conventional analgesia
Intervention Type
Procedure
Intervention Name(s)
ultrasound guided erector spinae plane block
Intervention Description
patients will receive combined general anesthesia and ultrasound guided erector spinae plane block with 20 ml of bupivacaine 0.2 % at T9 level bilaterally.
Intervention Type
Procedure
Intervention Name(s)
ultrasound guided paravertebral block
Intervention Description
patients will receive combined general anesthesia and ultrasound guided paravertebral block with 7 ml of bupivacaine 0.2 % at T8 and T10 bilaterally.
Intervention Type
Drug
Intervention Name(s)
conventional analgesia
Intervention Description
patients will receive combined general anesthesia and conventional analgesia
Primary Outcome Measure Information:
Title
First time to analgesic requirement
Description
all patients received an IV -PCA system (Accufuser M8P, 60 mL; Woo Young Meditech Co, S.Korea). PCA was prepared with 60 mL of isotonic saline containing 60 mg morphine, and the selected system was adjusted to infuse a 1 mL bolus dose with a lockout interval of 15 minutes while the basal flow rate was switched off. Breakthrough pain was managed with 2mg morphine.
Time Frame
1st 24 hour
Secondary Outcome Measure Information:
Title
total analgesic consumption
Description
The total dose of rescue analgesics(morphine) required in 24 hours will be recorded.
Time Frame
1st 24 hour
Title
Numerical rating scale (NRS)
Description
All patients will be monitored in the postoperative period for pain by the NRS score at rest and movement at immediate postoperative (0 min), 30 min, 1, 2, 6,12, and 24 hours.
Time Frame
1st 24 hour
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
patients who will be scheduled for indicated open splenectomy surgery in the supine position via left subcostal ,midline or letf subcostal with midline extention incisions
physical status American Society of Anesthesiologists (ASA) II or III.
Exclusion Criteria:
Patients who refuse to participate
patients with body mass index (BMI) >35 kg/m2
infection at the site of injection
coagulopathy, severe thrombocytopenia <50×103
spine deformity
history of opioid dependence
polytrauma patients with dorsal spine fracture
urgent abdominal exploration for splenectomy in heamodynamically unstable patients
history of allergy to opioids or local anesthetics
history of allergy to opioids, or local anaesthetics.
Facility Information:
Facility Name
Ain Shams University hospitals
City
Cairo
Country
Egypt
12. IPD Sharing Statement
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Ultrasound-guided Erector Spinae Plane Block Versus Paravertebral Block for Perioperative Analgesia in Patients Undergoing Open Splenectomy
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