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Rectus Sheath Block Versus Thoracic Epidural Effect on Diaphragmatic Function After Elective Midline Abdominal Surgery — Rectus  

Acute Pain Clinical Trial

Official title:
Comparison of the Effect of Rectus Sheath Block Versus Thoracic Epidural Analgesia on Diaphragmatic Function After Elective Abdominal Surgery With Midline Incision

Clinical Trial Summary

This study will be undertaken to compare the respiratory and analgesic effects of thoracic epidural versus ultrasound guided rectus sheath block analgesia after elective abdominal surgery with midline incision.

Clinical Trial Description

A major proportion of pain experienced by patients undergoing abdominal surgeries is due to somatic pain signals derived from the abdominal wall. The central portion of anterior abdominal wall components (skin, muscles and parietal peritoneum) is innervated by sensory neurons branching from the anterior rami of spinal nerves T7 to T1. These neurons lie between the rectus abdominis muscle and posterior rectus sheath, and pierce the rectus muscle close to the midline. The tendinous intersections of the rectus muscle do not fuse with the posterior rectus sheath, thereby allowing the injectate to spread cephalo-caudally within this potential space. Rectus sheath (RS) block has been described for any midline abdominal incisions (epigastric and umbilical hernia repairs). As visceral pain becomes attenuated by the 2nd postoperative day, rectus sheath block can also be administered for midline laparotomy.

As a single bolus of the local anesthetic has a maximum duration of 12 hours. it is necessary to insert a catheter into this space to allow either a continuous infusion of local anesthetic, or repeated boluses of local anesthetic every 8 to 12 hours for 48 to 72 hours post-operatively.

However, the effects of rectus sheath block catheter analgesia on the respiratory function after abdominal surgery with midline incisions are still under investigation. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details
NCT number NCT03725527
Study type Interventional
Source Assiut University
Contact Hala S Abdelghaffar, MD
Phone +2 01003812011
Email hallasaad@yahoo.com
Status Recruiting
Phase N/A
Start date May 1, 2020
Completion date January 1, 2021
View Details
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