Dose Esmolol Infusion Have an Adjuvant Effect to TAP Block for Pain Control in Laparoscopic Cholecystectomy.
Status:
Completed
Trial end date:
2021-07-20
Target enrollment:
Participant gender:
Summary
Pain after laparoscopy differs considerably from that seen after laparotomy. Laparotomy
results mainly in parietal pain (abdominal wall), where as Pain in laparoscopy results from
stretching of the intra-abdominal cavity, peritoneal inflammation, and diaphragmatic
irritation caused by residual carbon-dioxide in the peritoneal cavity. The transverse
abdominis plane (TAP) block is a peripheral nerve block designed to anesthetize the nerves
supplying the anterior abdominal wall (T6 to L1). While esmolol is an ultra-short acting
intravenous β-blocker having a rapid onset and offset effect. It provides an unprecedented
level of tolerability and safety in the perioperative setting. When used as an adjunct, it
has been shown to improve the postoperative recovery by reducing postoperative pain intensity
and intraoperative anesthetic and opioid requirements and preventing opioid-induced
hyperalgesia . The mechanism of this synergistic effect is uncertain, but both
pharmacokinetic and pharmacodynamics interactions with anesthetic drugs have been proposed.