Comparison Between Quadratus Lumborum Block and Transversus Abdominis Plane Block in Bladder Cancer Surgeries
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 63
- 试验地点
- 1
- 主要终点
- Time to first rescue dose of morphine
研究概览
简要总结
Transversus abdominis plane (TAP) block can be used to provide effective analgesia during the postoperative period following a range of surgeries.
TAP block administers local anesthetics between the T6 to L1 spinal nerve roots to stop the nerve signal and to alleviate pain for abdominal procedures 4, 5.
The viscera are innervated by the vagal nerve (parasympathetic innervation) and by the splanchnic nerves (sympathetic innervation). The splanchnic nerves carry both visceral efferent and afferent nerve fibers. The sensory (or afferent) part of the splanchnic nerves reach the spinal column at certain spinal segments, It is possible to block central visceral pain conduction with thoracic paravertebral blockade or maybe even with the novel quadratus lumborum (QL) block.
The effect of the QL block is believed to result from a spread of LA from its lumbar deposition cranially into the thoracic paravertebral space (TPVS), since Carney et al found traces of contrast agent in the TPVS following application of this block. Hence, the QL block would seem to be able to alleviate both somatic and visceral pain.10
The aim of this study is to compare between quadratus lumborum block, transversus abdominis plane block regarding perioperative analgesia after bladder cancer surgeries by measuring intraoperative hemodynamics, postoperative pain scores and morphine consumption in the first 24 h postoperative.
详细描述
Somatic post-surgical pain is very distressing to patients which leads to important complications. Combined multimodal strategies involving nerve blocks, neuroaxial blocks, opiates, and non-steroidal anti-inflammatory drugs are necessary for optimal pain control.
Transversus abdominis plane (TAP) block can be used to provide effective analgesia during the postoperative period following a range of surgeries.
TAP block administers local anesthetics between the T6 to L1 spinal nerve roots to stop the nerve signal and to alleviate pain for abdominal procedures.
A number of systematic reviews have assessed TAP block as a postoperative analgesic compared to one or more specific procedures.
Anterior abdominal wall blocks, as transverse abdominal plexus block, have an important role for only somatic intraoperative and postoperative pain control.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 20 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age of the patients between 20 to 80 years.
- •ASA physical status II -III
- •Elective bladder cancer operations.
排除标准
- •Patient refusal
- •Local infection at the site of injection
- •Allergy to study medications
- •Anatomic abnormalities
- •Systemic anticoagulation or coagulopathy
- •Inability to comprehend or participate in pain scoring system
研究组 & 干预措施
Control Group
Patients will receive general anesthesia with intravenous opioid
干预措施: Intravenous opioid (Drug)
Quadratus lumborum
Patients will receive bilateral quadratus lumborum block
干预措施: Quadratus lumborum block (Procedure)
Transversus abdominis plane
Patients will receive bilateral transversus abdominis plane block
干预措施: Transversus abdominis plane block (Procedure)
结局指标
主要结局
Time to first rescue dose of morphine
时间窗: 24 hours
First time at which morphine was given postoperatively (If Vsual analogue scale (VAS) was \>4, 3 mg morphine IV was administered as a rescue analgesia for the first 24 hours)
次要结局
- Total dose of postoperative morphine consumption(24 hours)
- Pain intensity by visual analogue scale (VAS)(24 hours)