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

NCT02379780 | Completed

• 1 other identifier: mengücek gazi hospital
• Study Type: interventional
• Target: 50
• Locations: 0 countries
• Sites: N/A

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.

Conditions

Cholecystitis

Outcome Measures

Primary Outcomes (1)

• anesthetic and opioid consumption during operation

  six months

Secondary Outcomes (2)

• postoperative VAS scores

  six months

• duration of analgesia

  six months

Study Arms (2)

USG guided Subcostal TAP block

ACTIVE COMPARATOR

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.

Procedure: USG guided Subcostal TAP block; Procedure: USG guided Paravertebral Block

USG guided Paravertebral Block

ACTIVE COMPARATOR

prior to start surgery, was performed in the left lateral position. after preparing skin, ultrasound linear probe was placed, 2-3 cm lateral of the T7 / T8 level in the midline. After determining the transverse process and ribs as hyperechoic, the paravertebral space was identified as an area wedge-shaped bounded by the pleura and above the internal intercostal membrane.after identification of the paravertebral space, the block needle was introduced in plane / out of plane and 10 ml of bupivacaine (Marcaine 0,25 %) and 5 ml of lidocaine (2%) was injected after negative aspiration.

Procedure: USG guided Subcostal TAP block; Procedure: USG guided Paravertebral Block

Interventions

USG guided Subcostal TAP block PROCEDURE

Ultrasonography Assisted Subcostal TAP blockage: In plane technique was applied and 22 G needle (BRAUN Stimuplex D Plus 0,71\*50 mm 22G\*2) was used. Intravascular injection was eliminated after the passage of rectus sheath by negative aspiration. 0,5-1 ml local anesthetic was applied directly to confirm the right place. 10 cc bupivacain ( 0,5 % Marcain flacon, Astra Zeneca, Sweeden) and 5 cc lidocaine was injected to the site. The same procedure was applied to the opposite site. we investigated amount of TIVA during the operation, postoperative Visual Analog Scores and the time that the pain free time.

USG guided Paravertebral Block; USG guided Subcostal TAP block

USG guided Paravertebral Block PROCEDURE

Ultrasonoraphy assisted Thoracic Paravertebral blockage application: In-plane or out-of-plane technique was used with stimuplex needle (BRAUN Stimuplec D Plus 0,71\*50 mm 22 G\* 2'', 15°). Popping sensation that was felt by the penetration of the internal intercostal membrane, guided to paravertebral space. Intravascular injection was eliminated by negative aspiration. 0,5 - 1 ml local anesthetic injection was administered to show the displacement of pleura downward that confirmed the place of the needle in the right place. Then 10 cc bupivacain (% 0.5 Marcaine® flacon, Astra Zeneca, Sweeden) and 5 cc lidocaine was injected to the site. we investigated amount of TIVA during the operation, postoperative Visual Analog Scores and the time that the pain free time.

USG guided Paravertebral Block; USG guided Subcostal TAP block

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Between 18-65 years of age,
• ASA I-II-III
• laparoscopic cholecystectomy to be applied

You may not qualify if:

• patient refusal
• mental and psychiatric disorders,
• allergy history of the drug to be used,
• kyphoscoliotic anatomical disorder
• patients with coagulopathies

Sponsors & Collaborators

• Cukurova University: lead
• Erzincan University: collaborator

Related Publications (8)

• Hebbard P. Subcostal transversus abdominis plane block under ultrasound guidance. Anesth Analg. 2008 Feb;106(2):674-5; author reply 675. doi: 10.1213/ane.0b013e318161a88f. No abstract available.

  PMID: 18227342 RESULT

• Williams SR, Chouinard P, Arcand G, Harris P, Ruel M, Boudreault D, Girard F. Ultrasound guidance speeds execution and improves the quality of supraclavicular block. Anesth Analg. 2003 Nov;97(5):1518-1523. doi: 10.1213/01.ANE.0000086730.09173.CA.

  PMID: 14570678 RESULT

• Cheema SP, Ilsley D, Richardson J, Sabanathan S. A thermographic study of paravertebral analgesia. Anaesthesia. 1995 Feb;50(2):118-21. doi: 10.1111/j.1365-2044.1995.tb15092.x.

  PMID: 7710020 RESULT

• El-Dawlatly AA, Turkistani A, Kettner SC, Machata AM, Delvi MB, Thallaj A, Kapral S, Marhofer P. Ultrasound-guided transversus abdominis plane block: description of a new technique and comparison with conventional systemic analgesia during laparoscopic cholecystectomy. Br J Anaesth. 2009 Jun;102(6):763-7. doi: 10.1093/bja/aep067. Epub 2009 Apr 17.

  PMID: 19376789 RESULT

• Ozkan D, Akkaya T, Comert A, Balkc N, Ozdemir E, Gumus H, Ergul Z, Kaya O. Paravertebral block in inguinal hernia surgeries: two segments or 4 segments? Reg Anesth Pain Med. 2009 Jul-Aug;34(4):312-5. doi: 10.1097/AAP.0b013e3181ae1169.

  PMID: 19574864 RESULT

• Mishriky BM, George RB, Habib AS. Transversus abdominis plane block for analgesia after Cesarean delivery: a systematic review and meta-analysis. Can J Anaesth. 2012 Aug;59(8):766-78. doi: 10.1007/s12630-012-9729-1. Epub 2012 May 24.

  PMID: 22622954 RESULT

• Thavaneswaran P, Rudkin GE, Cooter RD, Moyes DG, Perera CL, Maddern GJ. Brief reports: paravertebral block for anesthesia: a systematic review. Anesth Analg. 2010 Jun 1;110(6):1740-4. doi: 10.1213/ANE.0b013e3181da82c8. Epub 2010 May 6.

  PMID: 20448076 RESULT

• Aveline C, Le Hetet H, Le Roux A, Vautier P, Cognet F, Vinet E, Tison C, Bonnet F. Comparison between ultrasound-guided transversus abdominis plane and conventional ilioinguinal/iliohypogastric nerve blocks for day-case open inguinal hernia repair. Br J Anaesth. 2011 Mar;106(3):380-6. doi: 10.1093/bja/aeq363. Epub 2010 Dec 21.

  PMID: 21177284 RESULT

MeSH Terms

Conditions

Cholecystitis

Condition Hierarchy (Ancestors)

Gallbladder Diseases; Biliary Tract Diseases; Digestive System Diseases

Study Officials

• ILKE KUPELI

  MENGUCEK GAZI TRAINING AND RESEARCH HOSPİTAL

  PRINCIPAL INVESTIGATOR

• ZEHRA BEDİR

  MENGUCEK GAZI TRAINING AND RESEARCH HOSPİTAL

  STUDY CHAIR

• HUSEYIN EKEN

  MENGUCEK GAZI TRAINING AND RESEARCH HOSPİTAL

  STUDY CHAIR

• UFUK KUYRUKLUYILDIZ

  MENGUCEK GAZI TRAINING AND RESEARCH HOSPİTAL

  STUDY CHAIR

• DIDEM ONK

  MENGUCEK GAZI TRAINING AND RESEARCH HOSPİTAL

  STUDY CHAIR

• ORHAN BINICI

  MENGUCEK GAZI TRAINING AND RESEARCH HOSPİTAL

  STUDY CHAIR

• AYSIN ALAGOL

  MENGUCEK GAZI TRAINING AND RESEARCH HOSPİTAL

  STUDY DIRECTOR

• GULDANE KARABAKAN

  MENGUCEK GAZI TRAINING AND RESEARCH HOSPİTAL

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: specialist dr

Study Record Dates

• First Submitted: February 19, 2015
• First Posted: March 5, 2015
• Study Start: September 1, 2014
• Primary Completion: January 1, 2015
• Study Completion: February 1, 2015
• Last Updated: March 6, 2015

Record last verified: 2015-03