The Application of Transversus Abdominis Plane Block Plus Rectus Sheath Block in Clinical Anesthesia
Status:
Unknown status
Trial end date:
2018-05-01
Target enrollment:
Participant gender:
Summary
Peritoneal dialysis (PD) catheter placement surgery for patients with end-stage renal disease
(ESRD) can be performed under peripheral nerve block. This study assessed the ability of
ultrasound guided left lateral transversus abdominis plane (TAP) block combined with rectus
sheath (RS) block in PD catheter placement surgery. Also, surgeries are common surgeries
performed in elderly patients throughout the world. Although there is an increasing trend
towards laparoscopic surgeries, open procedures continue to remain common therapeutic
modalities especially in the developing countries. Pain is reported more commonly in patients
undergoing open procedures than laparoscopic procedures. Postoperative pain and tissue injury
associated with surgery initiated a systemic stress response which has neuroendocrine,
immunological, and haematological responses. Opioids are an important modality of
postoperative pain management. They blunt the neuroendocrine stress response to pain.
However, they are associated with several adverse effects like respiratory depression,
nausea, vomiting , pruritus, constipation, urinary retension, bradycardia and hypotension.
Transversus abdominis plane block（TAPB）is a relative novel procedure in which local
anesthetic agents are injected into the anatomic plane between the internal oblique and the
transversus abdominis muscle. It allows a significantly prolonged duration of analgesia
during the early postoperative stage in abdominal surgery. This regional anesthesia technique
provides analgesia to the skin, muscles of the anterior abdominal wall and parietal
peritoneum in order to decrease the incision-related pain. Thus, it reduces postoperative
opiate requirements and opioids-related side effects (nausea, vomiting, delayed resumption of
intestinal transit, drowsiness, respiratory depression, urine retention). Nalbuphine, being
mu antagonist an kappa agonist, has a ceiling effect in its respiratory depression. Many
studies have reported that incidence of adverse effects like pruritus and PONV is lower with
nalbuphine in comparison with morphine. The purpose of this study is to compare the analgesic
efficacy and side effect profile of sulfentanyl with nalbuphine in elderly patients
undergoing open gastrointestinal surgeries.
Phase:
N/A
Details
Lead Sponsor:
The First Affiliated Hospital of Anhui Medical University