Postoperative Pain Clinical Trial
Official title:
Comparison Between Ultrasound-Guided Transversus Abdominis Plane Block and Ultrasound-Guided Erector Spinae Plane Block in Postoperative Analgesia for Lower Abdominal Cancer Surgery. Randomised Double Blinded Control Study
The aim of this study is to compare the analgesic effect and safety profile of erector spinae plane block with transverses abdominis plane block in controlling peri-operative pain for lower abdominal cancer surgery.
Pain triggers a complex biochemical and physiological stress response leading to impairment
of pulmonary, immunological and metabolic functions. Opioids are the current gold standard
drug for postoperative pain relief, however exposure to large doses lead to multiple side
effects of varying significance such as nausea, vomiting, dizziness, constipation,
respiratory depression, hypoventilation and sleep breathing disorders. Therefore strategies
other than opioids are recommended without sacrificing proper and effective analgesia.
Especially in cancer patients who are more susceptible to tolerance and addiction.
The Transversus Abdominis Plane (TAP) block, is a regional anaesthesia technique used
effectively in laparotomies. Unilateral analgesia to the skin, muscles, and parietal
peritoneum of the anterior abdominal wall will be achieved without affecting visceral pain,
when the anterior rami of the lower six thoracic nerves (T7-T12) and the first lumbar nerve
(L1) are blocked.
Erector spinae plane block (ESPB) was shown to be an effective analgesic option for different
types of surgeries. It's relatively a simple block, drug is injected in the plane between the
erector spinae muscle and the vertebral transverse process. Blocking the ventral and dorsal
rami of spinal nerves on the paravertebral area distributed from T2-T4 to L1-L2 and gives
good coverage to visceral pain. Owing to the lower risk of blood vessel damage and neural
damage compared to the epidural or the paravertebral block.
Both blocks haven't been compared to each other in this type of surgery before.
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