The Effect of Subcostal Anterior Quadratus Lumborum Block on the Incidence of Chronic Neuropathic Pain After Retroperitoneal Laparoscopic Donor Nephrectomy: A Study on Neuroinflammation and Neurophysiology

Neuropathic Pain Incidence: Neuropathic Pain in 4 Questionnaire

时间窗: 3 months after intervention

Pain that develops after a surgical procedure in the area of surgery and its radiation, persists for at least 3 months after surgery, other causes of pain (e.g. infection and history of malignancy) or pre-existing pain have been excluded. Total score: 10 Score ≤ 4 = no pain developed Score ≥ 4 = pain developed

Neuromodulation Parameter: Degree of functional interference using Behavioral Pain Interference (BPI)

时间窗: At 3 months after intervention

The degree of pain that develops after a surgical procedure in the area of surgery and its radiation, persisting for at least 3 months after surgery, other causes of pain (eg infection and history of malignancy) or pre-existing pain have been excluded. Behavioral Pain Interference (BPI) questionnaire based on the average of questions 4, 5, and 6 1. Mild (NRS 1-3) 2. Moderate (NRS 4-6) 3. Severe (NRS 7-10)

Chronic Pain Severity: Leeds Assesment of neuropathic symptoms and sign (LANSS) scale

时间窗: At 3 months after intervention

A measuring tool used to assess neuropathic pain and provides information to differentiate nociceptive pain from neuropathic pain. Total score: 24 \<12: Not neuropathic \>12: Neuropathic pain

Neuroinflammation Parameter: Serum Concentration of Toll-like Receptor 4 (TLR4)

时间窗: At 3 months after intervention

Transmembrane receptors in the innate immune system. Units: ng/mL

Neuroinflammation Parameter: Serum Concentration of Calcitonin gene-related peptide (CGRP)

时间窗: At 3 months after intervention

Neuropeptides that play a role in pain transmission and vasodilation Unit: pg/mL

Neuroinflammation Parameter: Serum Concentration of Nerve Growth Factor (NGF)

时间窗: At 3 months after intervention

Neurotrophic factors that play a role in promoting the growth and survival of sensory neurons Unit: pg/mL

Neurophysiology Parameter: Mechanical Detection Threshold (MDt)

时间窗: At 3 months after intervention

Measures the minimum force needed for a person to perceive a light mechanical stimulus, tested using von Frey filaments. Skin contact test for 2 seconds using 1 set of von Frey filaments. The examination is performed in m. trapezius. Unit: mN Lower result means: higher sensitivity (normal or hypersensitivity) Higher result means: Reduced sensitivity, could indicate hypoesthesia or nerve damage

Neurophysiology: Mechanical Pain Threshold (MPt)

时间窗: At 3 months after intervention

Accurate measurement of pain threshold. Skin contact test using repeated pinpricks at the same location. Comparative assessment of initial pain scale with pain scale after repeated stimulation. Examination is performed at m. trapezius. Unit: Numerical Rating Scale (NRS) from 1 to 10 Lower NRS: higher sensitivity to pain Higher NRS: lower sensitivity to pain

Neurophysiology Parameter: Pressure Pain Threshold (PPt)

时间窗: At 3 months after intervention

Pain tolerance examination. Pressure assessment in kgf/cm2 units where the patient complains of pain according to the stimulus given. The examination is carried out in m. trapezius Units: kgf/cm2. Lower PPT: Increased pain sensitivity Higher PPT: Decreased pain sensitivity

Neurophysiology Parameter: Mechanical Temporal Summation of Pain (MTSP)

时间窗: At 3 months after intervention

Evaluates central sensitization by applying repeated light mechanical stimuli and rating how pain builds up over time. Pressure assessment in kgf/cm2 units where the patient complains of pain according to the stimulus given. The examination is carried out in m. trapezius. Units: Verbal Numeric Scale (VNS) from 1 to 10 Higher MTSP score: Indicates central sensitization Lower MTSP score: Normal pain processing

Neuromodulation Parameter: Serum Concentration of beta-Endorfin

时间窗: At 3 months after intervention

Neuropeptide produced in the anterior pituitary and brain, as an endogenous opioid. Units: pg/mL