Comparison of Ultrasound Guided Quadratus Lumborum Block With Ultrasound Guided TAP Block for Postoperative Analgesia After Laparoscopic Nephrectomy: a Prospective Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Postoperative Pain
- Sponsor
- Post Graduate Institute of Medical Education and Research, Chandigarh
- Enrollment
- 96
- Locations
- 1
- Primary Endpoint
- Cumulative morphine consumption in 24 hours in milligrams
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
This is a randomised controlled trial which will compare the Quadratus Lumborum (QL) Block with the Transversus Abdominis Plane (TAP) Block in terms of analgesic efficacy, ease of performance and safety when administered postoperatively in patients who undergo laparoscopic nephrectomy.
To fulfill this purpose, three groups of patients each with 32 patients, will be formed. Patients in the Transversus Abdominis Plane (TAP) group and Quadratus Lumborum (QL) group will each receive the respective blocks with 0.4 ml/kg of 0.25% Bupivacaine, after completion of surgery. The third (Control group) will not receive any blocks. After shifting patients to recovery all three groups will be put into intravenous patient controlled analgesia (PCA) Morphine as rescue analgesic regimen as per a set protocol. Morphine consumption over the first postoperative 24 hours, ease of performance of individual blocks and associated adverse events, adverse events associated with opioid use, patient recovery and satisfaction will be noted.
Investigators
Kritika Rathour
Junior Resident, Department of Anaesthesia and Intensive Care
Post Graduate Institute of Medical Education and Research, Chandigarh
Eligibility Criteria
Inclusion Criteria
- •patients between 18-65 years of age,
- •ASA class I or II,
- •undergoing elective unilateral laparoscopic nephrectomy
- •under general anaesthesia
Exclusion Criteria
- •Patients with any of the following:
- •refusal to participate in the study
- •coagulopathy/ thrombocytopenia
- •localised infection at the proposed site of injection
- •inability to comprehend the scoring systems to be employed or use PCA due to physical or mental problems
- •known allergy to the drugs to be used (local anesthetics, opioids)
- •opioid tolerance/ dependence
- •renal impairment
- •hepatic impairment
- •known cardio-respiratory impairment
Outcomes
Primary Outcomes
Cumulative morphine consumption in 24 hours in milligrams
Time Frame: within the first 24 hours after surgery
Secondary Outcomes
- Incidence of adverse effects related to opioid use (derrived from incidence of nausea and vomiting, sedation and respiratory depression)(within the first 24 hours after surgery)
- Incidence of block related complications(within the first 24 hours after surgery)
- Pain scores at rest and on movement as measured by numeric rating scale (0 to 10)(within the first 24 hours after surgery)
- Patient satisfaction as measured by numeric rating scale (0 to 10)(24 hours after surgery)
- Time to first demand of rescue analgesic in hours(within the first 24 hours after surgery)
- Ease of performing the respective blocks (assessed by time required to perform the blocks in minutes and number of attempts required to perform the blocks)(while performing block)