Laparoscopic Cholecystectomy Clinical Trial
Official title:
Erector Spinea Plane Block Versus Peritoneal Block Analgesia in Laparoscopic Cholecystectomy
The aim of this study is to detect weather peritoneal block or erector spinae plane block
will provide the most ideal analgesia for patients undergoing laparoscopic cholecystectomy.
Peritoneal block by instillation of local anesthetic into the peritoneal cavity will act by
blocking the free afferent nerve endings in the peritoneum and the systemic absorption of
local anesthetic from the peritoneal cavity may also play a part in reduced pain.
On the other hand ,the erector spinae plane block is a novel analgesic technique that provide
both visceral and somatic analgesia due to its communication with the paravertebral space.
Local anesthetic mixture of lidocaine , magnesium sulphate and epinephrine will be used for
both techniques.
The pain that a patient feels after laparoscopic cholecystectomy results from three different
and clinically separate components: somatic pain due to trocar insertion sites , visceral
pain due to surgical dissection and tissue handling at the gall bladder bed, and shoulder
pain due to retention of carbon dioxide in the abdomen, which irritates the phrenic nerve and
diaphragm. Ineffective treatment of post laparoscopic cholecystectomy pain may delay recovery
and mandate inpatient admission and therapy and increase the cost of such care.
The aim of this study is to evaluate the analgesic effect of Erector spinea plane block in
comparison with peritoneal block for laparoscopic cholecystectomy. Serum level of cortisol as
a stress biomarker ,perioperative primary hemodynamics ,visual analogue scale , patient
request for rescue analgesia and occurrence of side effects are the parameters for comparison
between both techniques. Each patient will be followed up for 24 hours postoperatively.
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