Comparison of Quadratus Lumborum Block and Epidural Analgesia Following Kidney Transplant Surgery
- Conditions
- Postoperative Pain
- Interventions
- Procedure: Continuous Epidural analgesiaProcedure: Bilateral Quadratus Lumborum block
- Registration Number
- NCT03771339
- Lead Sponsor
- Indonesia University
- Brief Summary
Quadratus lumborum block as an alternative for postoperative analgesia compared with epidural block
- Detailed Description
Epidural analgesia is the main choice of analgesia following kidney transplant surgery. However, continuous epidural technique had some concerning side effects such as hemodynamic instabilities, urine retention, motor/sensory disturbances/weakness, and mobilisation comfort, it could also cause hypotension which could affect graft success. Quadratus lumborum (QL) block had lesser side effects thus could be an option for postoperative analgesia, however there are no study showing the safety and success rate of QL block techniques for patients who underwent kidney transplant surgery.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 50
- Patients undergoing elective kidney transplant laparotomy surgery
- Agrees to participate in research
- BMI < 30 kg/m2
- Declines to participate in research
- Contraindications to intervention procedures (epidural or quadratus lumborum block)
- History of local anaesthetic allergy
- Systemic allergic reactions, anaphylactic reaction, cardiac arrest
- Failure of intervention procedures (epidural or quadratus lumborum block)
- Intraoperative complications (massive bleeding, hypotension)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Continuous Epidural Analgesia Continuous Epidural analgesia Continuous epidural analgesia using ropivacaine 0.375% 3 mL boluses followed by ropivacaine 0.2% with rate 6 mL per hour for 24 hours Bilateral Quadratus Lumborum Block Bilateral Quadratus Lumborum block Bilateral Quadratus lumborum block using ropivacaine 0.2% 20 mL each injection after surgery
- Primary Outcome Measures
Name Time Method Morphine consumption 24 hours Additional analgesia required at 2, 6, 12, and 24 hours after surgery
- Secondary Outcome Measures
Name Time Method Blood ropivacaine level 24 hours Arterial blood sample of all subjects will be withdrawn approximately 3 mL from the arterial line at 0, 30, 45, 60 minute, and 2, 4, 6,12,18, 24 hours after designated analgesia procedure, and will be used for ropivacaine blood level measurements using High-Performance Liquid Chromatography (HPLC), to measure Total plasma ropivacaine concentration (Cstop), maximum plasma concentration (Cmax), time of maximum plasma concentration, area under the curve (AUC)
Urine output 24 hours Urine output (mL/kgBW/hour) after surgery
Total minimum and maximum dose of vasoactive agents 24 hours Minimum and maximum dose of norepinephrine and dobutamine as vasoactive agents within 24 hours after surgery
First time morphine required 24 hours Total time gap from postoperative analgesia procedure administration to first morphine requirement
Bromage score 24 hours Bromage score at 2, 6, 12, and 24 hours after surgery to assess lower limb motoric block.
Score for Bromage:
1. free movement
2. partial block
3. almost complete
4. complete blockRamsay score 24 hours Ramsay score at 2, 6, 12, and 24 hours after surgery to assess patient sedation level.
Dermatomal coverage of analgesia procedure Immediately after anaesthesia completion dermatome sensory block distribution using cold sensation test
Pain Intensity 24 hours Pain intensity measured using the Visual Analogue Scale (VAS) at 2, 6, 12, and 24 hours after surgery. VAS assessed with horizontal line 0-100 mm for no pain to the worst pain, with range 0-30 mm for none to mild pain, 31-70 mm for moderate pain, 71-100 mm for severe pain.
Trial Locations
- Locations (1)
Rumah Sakit Cipto Mangunkusumo
🇮🇩Jakarta Pusat, DKI Jakarta, Indonesia