Comparison of Quadratus Lumborum Block using Bupivacaine with Dexmedetomidine versus Intrathecal Morphine for Postoperative Analgesia in Laparoscopic Nephrectomies-A randomized study

Laparoscopic Nephrectomies are complex surgical procedures that often result in significant postoperative pain. Effective pain management is crucial for patient recovery and satisfaction. Intrathecal Morphine (ITM) and various regional blocks like Quadratus Lumborum Block (QLB), Erector Spinae Plane Block (ESPB), and Transverse Abdominis Plane (TAP) Block have been used as a part of multimodal analgesia. [1] Intrathecal Morphine (ITM) provide better analgesia for around 24 hours at a significantly lower dose in comparison to intravenous opioids [2]. However, it does have an increased risk for side effects like pruritus, nausea, vomiting, and respiratory depression.  There is paucity of clinical studies exploring the comparative efficacy of Intrathecal Morphine versus Quadratus Lumborum block using Bupivacaine with Dexmedetomidine in laparoscopic nephrectomies, so we have planned this study to compare these two modalities.

References:

1. Srinivasan S, Subramaniam R, Chhabra A, Baidya D, Arora M, Maitra S, et al. Comparison of transversus abdominis plane block and intrathecal morphine for laparoscopic donor  nephrectomy: Randomized controlled trial. Indian J Anaesth. 2020 Jun 1;64(6):507–12. â€‹

2. Koning M V., Klimek M, Rijs K, Stolker RJ, Heesen MA. Intrathecal hydrophilic opioids for abdominal surgery: a meta-analysis, meta-regression, and trial sequential analysis. Vol. 125, British Journal of Anaesthesia. Elsevier Ltd; 2020. p. 358–72.