Transversus Abdominis Plane Block Versus Paravertebral Block for Post Operative Pain Relief in Open Renal Surgeries

NCT ID: NCT04697420

Last Updated: 2023-02-01

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2017-11-01
• Study Completion Date: 2019-01-23

Brief Summary

Pain relief after renal surgeries is essential as it may lead to reduction in the incidence of many post operative complications .

There are a lot of regional anesthetic techniques to provide analgesia postoperatively as paravertebral block (PVB) and transversus abdominis plane (TAP) block.

TAP block has been used to provide postoperative analgesia in a lot of abdominal surgeries including upper abdominal surgeries.It is safer technique than PVB, but the effectiveness of TAP block is unknown in comparison with PVB in post operative analgesia after renal surgeries .

Detailed Description

Pain relief after renal surgeries is essential as it may lead to reduction in the incidence of post operative respiratory complications . A lot of patients presented to these operations may have comorbidities as impaired renal function and respiratory problems , conditions like these may contraindicate aministration of systemic analgesia as opioids .

There are a lot of techniques to provide analgesia postoperatively as paravertebral block (PVB) and transversus abdominis plane (TAP) block .

Paravertebral block is effective technique for post operative analgesia for upper abdominal surgeries , but it may be associated with some complications as : pneumothorax , spread of local anesthetic to the epidural space and paravertebral blood vessels , and this may lead to systemic toxicity of local anesthetic .

TAP block has been used to provide postoperative analgesia in a lot of abdominal surgeries including upper abdominal surgeries , but it is safer technique than PVB , but the effectiveness of TAP block is unknown in comparison with PVB in post operative analgesia after renal surgeries .

Conditions

Postoperative Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Group (P)

the patients were received paravertebral block to control pain postoperatively.

Group Type: EXPERIMENTAL

Thoracic paravertebral block

Intervention Type: PROCEDURE

Thoracic paravertebral block is a technique in which , the local anesthetic agent is injected in the paravertebral space to anesthetise the spinal nerves after emerging from the vertebral canal in order to provide analgesia in the thoracic and upper abdominal area .

Group (T)

the patients were received transversus abdomins plane (TAP) block to control pain postoperatively.

Group Type: EXPERIMENTAL

Transversus abdominis plane block

Intervention Type: PROCEDURE

Transversus abdominis plane block is a technique is mostly done under ultrasound guidance to identify the transversus plane between the internal oblique muscle and the transverses abdominis muscle , the space in which the neurovascular supply of the anterior abdominal wall is present , and hence the injection of local anesthetic agent in this space results in anesthesia of the anterolateral aspect of the abdominal wall.

Interventions

Thoracic paravertebral block

Thoracic paravertebral block is a technique in which , the local anesthetic agent is injected in the paravertebral space to anesthetise the spinal nerves after emerging from the vertebral canal in order to provide analgesia in the thoracic and upper abdominal area .

Intervention Type: PROCEDURE

Transversus abdominis plane block

Transversus abdominis plane block is a technique is mostly done under ultrasound guidance to identify the transversus plane between the internal oblique muscle and the transverses abdominis muscle , the space in which the neurovascular supply of the anterior abdominal wall is present , and hence the injection of local anesthetic agent in this space results in anesthesia of the anterolateral aspect of the abdominal wall.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Aged 18 - 60 years
• ASA I-II class

Exclusion Criteria

• Patient refusal
• Any contraindication of regional anesthesia block (Coagulopathy,infection at the needle insertion site)
• Patients with allergy to amide local anesthetics or medication included in the study.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Assiut University

OTHER

Sponsor Role: lead

Responsible Party

Abdelrahman Hussein Ali

Resident doctor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Essam Ezzat, Professor

Role: STUDY_DIRECTOR

Professor of anesthesia, intensive care and pain management , formerly head of the department

Locations

Assiut University

Asyut, , Egypt

Countries

Egypt

Other Identifiers

AHAAssiut

Identifier Type: -

Identifier Source: org_study_id