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Not yet recruiting NCT07582029

Ultrasound-Guided Rectus Sheath Block Versus Local Infiltration

No phase Interventional Cholelithiases Cholecystitis Postoperative Pain

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Rectus Sheath Block, Local Anesthetic Infiltration.
Who it may be relevant to
Registry conditions: Cholelithiases, Cholecystitis, Postoperative Pain. Basic parameters: from 18 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
Turkey (Türkiye)
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →

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Official title

Comparison of the Analgesic Effects of Local Anesthetic Infiltration and Ultrasound-Guided Rectus Sheath Block in Laparoscopic Cholecystectomy Operations: A Prospective Randomized Controlled Study

Overview

Laparoscopic cholecystectomy is associated with significant postoperative pain originating from trocar sites, pneumoperitoneum, and visceral irritation. Both local anesthetic infiltration and ultrasound-guided rectus sheath block are commonly used regional analgesic techniques to reduce postoperative pain and opioid consumption. This prospective randomized controlled study aims to compare the effects of these two techniques on postoperative pain scores, opioid requirements, and analgesia-related adverse effects following laparoscopic cholecystectomy.

Detailed description

Laparoscopic cholecystectomy is a very commonly performed and painful surgical procedure. The etiology of pain is complex and commonly includes pain related to trocar insertion sites, pain secondary to carbon dioxide insufflation, visceral pain, and shoulder pain. Various analgesic medications and regional anesthesia techniques are used for postoperative pain management. Abdominal wall blocks are frequently utilized to reduce opioid-related adverse effects.

Rectus sheath block is a regional anesthesia technique that blocks the anterior cutaneous branches of the lower thoracic nerves (T7-T12) and is used for analgesia in laparoscopic surgeries. Several studies have demonstrated that local anesthetic infiltration provides effective analgesia in laparoscopic cholecystectomy. Although rectus sheath block is an old technique traditionally used in midline surgeries, its analgesic use in laparoscopic procedures has increased in recent years.

In this prospective randomized clinical trial, we aimed to compare the effects of Local Anesthetic Infiltration and Rectus Sheath Block on opioid consumption and pain scores in laparoscopic gallbladder surgery.

To compare the effects of Local Anesthetic Infiltration and Rectus Sheath Block on opioid consumption and pain scores in laparoscopic gallbladder surgery.

Interventions

  • Procedure Rectus Sheath Block
    After completion of the operation, during the surgical closure phase, bilateral rectus sheath block will be performed. A linear ultrasound probe will be placed transversely over the umbilicus and 1 cm lateral to it. After visualization of the rectus abdominis muscle and posterior rectus sheath, a 22-Gauge 80 mm block needle (Braun Stimuplex Ultra-360, Melsungen, Germany) will be advanced from lateral to medial using the in-plane technique. Following hydrodissection with 1 mL saline between the r
  • Procedure Local Anesthetic Infiltration
    At the end of the operation, the surgeon will infiltrate 5 mL local anesthetic (0.5% bupivacaine) subcutaneously into each of the four trocar insertion sites.

Primary outcome measures

  • NRS Score [Time frame: Pain scores will be assessed and recorded at postoperative 0, 1, 4, 12, and 24 hours.]
Secondary outcome measures (2)
  • Opioid Consumption [Time frame: 24 hour]
  • Adverse Effects [Time frame: 24 hour]

Eligibility criteria

Inclusion criteria

  • ASA (American Society of Anesthesiologists) class I-II patients
  • Patients aged between 18 and 65 years
  • Patients undergoing laparoscopic cholecystectomy surgery

Exclusion criteria

  • ASA class III-IV patients
  • Patients undergoing emergency surgery
  • Relatives of patients who do not provide consent
  • Presence of chronic pain
  • Chronic opioid use
  • Presence of local anesthetic allergy
  • Ibuprofen allergy
  • Paracetamol allergy
  • Presence of infection at the block site
  • Coagulopathy
  • Increased intracranial pressure
  • Pre-existing neurological deficit
  • Severe organ failure
  • Mental retardation
  • Anatomical deformity

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation
Randomized
Model
Parallel assignment
Masking
Double blind
Primary purpose
Treatment

Study locations

Turkey (Türkiye) · 1 center
  • Sisli Hamidiye Etfal Training Hospital — Istanbul

Identifiers

NCT: NCT07582029 · zeynep-1

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗