Effect of Preincisional Bupivakain Infiltration on Postoperative Narcotic Medication Requirement
Study Details
Study Description
Brief Summary
Postoperative pain and use of narcotic analgesics after laparoscopic bariatric surgeries are problems that need to be solved in terms of patient comfort. We believe that preincisional bupivacain injection to the trocar sites will help us for these problems. A study is designed focused on reduced postoperative pain and reduced use of narcotic analgesics by preincisional bupivacain injection for laparoscopic bariatric patients.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
A randomised controlled prospective study is designed with 40 patients over 2-month period (January 2017 to february 2017). Laparoscopic sleeve gastrectomy is planned for all patients. Two groups are designed depending on whether trocar site infiltration with bupivacaine was performed (study group, 20 patients) or not (control group, 20 patients). The patients with body mass index (BMI) ≥35kg/m2 are enrolled to study. The parameters of demographic characteristics (age, gender, BMI, weight, and body fat percentage), preoperative comorbid conditions (type 2 diabetes mellitus, hypertension), and clinical outcomes (postoperative complications, mortality, readmissions) are planned to record.
Pain evaluation
Visual analogue scale (VAS, 0: no pain, 10: the worst imaginable pain) is planned to be used.
VAS measurements timing is planned as follows:
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first postoperative day: 4th, 8th, 12th, and 24th hours
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second postoperative day: 48th hour.
Operative Technique
All patients will be operated by same surgeons and anesthetist. Peroperatively intravenous paracetamol 10 mg, tramadol 50 mg and fentanyl 150 mcg will be used for analgesia. Local infiltration of the port sites was carried out through out all layers with 40 ml 0.25% bupivacaine and 1:200,000 epinephrine before incision. Laparoscopic sleeve gastrectomy will be performed with 5 trocars, in reverse trandelenburg position by creating pneumoperitoneum with 14 mmHg carbon dioxide insufflation. Trocar replacements are one 10-mm trocar in the midline above umbilicus for the endoscope, one 12-mm trocar to right midclavicular line linage to the 10-mm trocar. One 5-mm trocar to the left midclavicular line linage to the 10-mm trocar, one 5-mm trocar to the front axiller line below the left costal margin, and 5-mm trocar 2 cm below the xiphoid process for liver retractor. 38 F orogastric tube will be used. No use of nasogastric tubes and urinary catheters routinely is planned. Drain replacement is planned for all patients.
Postoperative Management
All patients will be mobilised 4th postoperative hour, and all patients will use breathing exercise device hourly. Postoperative analgesia protocol is designed with intravenous paracetamol 1 g every 8 h and deksketoprofen trometamol 50 mg every 12 h, antiemetics (ondansetron 4 mg every 8 h). Narcotic analgesic pethidin hcl 50 mg/ml will be ordered to patients who had > 5 degrees of pain according to VAS. The patients are Oral liquid diet was started on the second postoperative day, advanced to semisolid diet after discharging.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Study group Preincisional bupivacain will be used |
Procedure: study group
local anesthetic drug will be used
|
| Control group No preincisional anesthetic drug will be used |
Procedure: control group
no local anesthetic drug will be used
|
Outcome Measures
Primary Outcome Measures
- postoperative pain [postoperative 48 hours]
VAS scale will be used
- postoperative narcotic drug need [postoperative 48 hours]
VAS scale will be used
Eligibility Criteria
Criteria
Inclusion Criteria:
- Patients who are eligible for bariatric surgery
Exclusion Criteria:
- Refusal for participating to the study
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Nazif Bagriacik Kadikoy Hospital | Istanbul | Kadikoy | Turkey | 34718 |
Sponsors and Collaborators
- Umraniye Education and Research Hospital
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- PREINS-BUP-POSTOP-NARCOTIC-REQ