Quadratus Lumborum Block vs Transversus Abdominis Plane Block for Post-prostatectomy Analgesia
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 发起方
- 入组人数
- 12
- 试验地点
- 1
- 主要终点
- Total oxycodone used in the first 24 hours after surgery
研究概览
简要总结
Recently, the uses of peripheral axial blocks that deliver local anesthetic into the transversus abdominis fascial plane have become popular for operations that involve incision(s) of the abdominal wall. Thus, the Transversus Abdominis plane (TAP) block has been shown to reduce perioperative opioid use in elective abdominal surgery, including open appendicectomy, laparotomy, and laparoscopic cholecystectomy.
Currently, the Quadratus Lumborum block (QL block) is performed as one of the perioperative pain management procedures for all generations (pediatrics, pregnant, and adult) undergoing abdominal surgery. The local anesthetic injected via the approach of the posterior QL block ( QL 2 block ) can more easily extend beyond the TAP to the thoracic paravertebral space or the thoracolumbar plane, the posterior QL block entails a broader sensory-level analgesic and may generate analgesia from T7 to L1. Use of posterior QL block in laparoscopic prostatectomy has not been investigated before and it is the variant that will be discussed in our study.
详细描述
In laparoscopic prostatectomy, overall pain is a conglomerate of three different and clinically separate components: incisional pain (somatic pain), visceral pain (deep intra abdominal pain), and shoulder pain due to peritoneal stretching and diaphragmatic irritation associated with carbon dioxide insufflation. Moreover, it has been hypothesized that intense acute pain after laparoscopic prostatectomy may predict development of chronic pain. Without effective treatment, this ongoing pain may delay recovery, mandate inpatient admission, and thereby increase the cost of such care.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
盲法说明
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 90 Years（Adult, Older Adult）
- 性别
- Male
- 接受健康志愿者
- 否
入选标准
- •Pateints who will have prostatectomy ASA II or III
排除标准
- •Patient refusal Local infection at the site of injection Allergy to study medications Sepsis Anatomic abnormalities Systemic anticoagulation or coagulopathy Inability to comprehend or participate in pain scoring system Inability to use intravenous patient controlled analgesia
研究组 & 干预措施
Quadratus Lumborum block group
Quadratus Lumborum block group (QL) patients will receive a bilateral Quadratus Lumborum block using Bupivicaine 0.125%
干预措施: Quadratus Lumborum block (Diagnostic Test)
Quadratus Lumborum block group
Quadratus Lumborum block group (QL) patients will receive a bilateral Quadratus Lumborum block using Bupivicaine 0.125%
干预措施: Bupivacaine (Drug)
Transversus abdominis plane block group
Transversus abdominis plane block (TAP) patients will receive a bilateral TAP block using Bupivicaine 0.125%
干预措施: Tranversus Abdominis plane block (Diagnostic Test)
Transversus abdominis plane block group
Transversus abdominis plane block (TAP) patients will receive a bilateral TAP block using Bupivicaine 0.125%
干预措施: Bupivacaine (Drug)
结局指标
主要结局
Total oxycodone used in the first 24 hours after surgery
时间窗: 24 hours
Total cumulative oxycodone dose in mg used in the first 24 hours after surgery
次要结局
- Severity of postoperative pain via visual analogue pain scale (VAS)(24 hours)
研究者
Tomasz Skladzien
MD PHD
Jagiellonian University