Efficacy of transmuscular quadratus lumborum block versus erector spinae plane block for providing analgesia in patients undergoing percutaneous nephrolithotomy under general anaesthesia – A randomized controlled trial
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- To determine the duration of analgesia provided by both techniques
研究概览
简要总结
Percutaneous Nephrolithotomy (PCNL) is currently one of the most efficient and commonly performed urological procedures and is the gold-standard treatment modality for large renal stones. Despite limiting the size of the skin incision, the use of continuous irrigation causing pelvicalyceal dilatation and the insertion of a nephrostomy tube can result in severe postoperative pain for the patient which further contributes to restricted ambulation, prolonged recovery and a longer hospital stay. Given the frequency at which the surgical procedure is being performed, it is essential that we investigate and identify the best possible method of providing analgesia for these patients.
Regional anaesthesia provides many benefits including ease of performance, remarkable safety profile and decreased opioid consumption. The gold standard approaches to pain management in PCNL surgeries are epidural analgesia and thoracic paravertebral blocks, however the technically complexicity and associated complications have lead to the emergence of simpler and effective regional blocks. Literature review has revealed that the transmuscular quadratus lumborum block (TQLB) and the erector spinae plane block (ESPB) have shown much promise when compared to other regional techniques or the use of opioid analgesia. However, there has never been a published study comparing the efficacy of these two regional approaches for PCNL surgery. With this study we aim to compare the analgesic efficacy of TQLB and ESPB in patients undergoing PCNL surgery.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 盲法
- Participant, Investigator and Outcome Assessor Blinded
入排标准
- 年龄范围
- 18.00 Year(s) 至 89.00 Year(s)（—）
- 性别
- All
入选标准
- •Adult patients aged 18 to 89 years posted for unilateral percutaneous nephrolithotomy under general anaesthesia.
- •Patients belonging to ASA I to III physical status.
排除标准
- •Pregnant women 2) Patients with coagulopathies, thrombocytopenia 3) Infection at proposed site of infection 4) Hypersensitivity or known allergy to local anaesthetics 5) Patients with musculoskeletal deformities of the spine 6) Patients with psychiatric illness or cognitive dysfunction 7) Patients with uncontrolled hypertension 8) Patients on beta blockers.
结局指标
主要结局
To determine the duration of analgesia provided by both techniques
时间窗: Duration of analgesia measured starting from the time of block administration in the operation theatre till the first analgesic demand by the patient in the postoperative period in the ward, measured in minutes.
次要结局
- Intraoperative haemodynamic responses to pain and surgical stimulation – Heart rate (beats per minute), systolic blood pressure (mm Hg), diastolic blood pressure (mm Hg) and mean arterial pressure (mm Hg).(Intraoperative period)
- Numeric Rating Scale to assess severity of pain.(6, 12, 24 and 48 hours post operatively)
- Number of rescue boluses of Inj. Pethidine in the first 24 hours after surgery and total dose (mg) provided during hospital stay in 24 hours.(24 hour period after surgery)
- iv. Side effects – hypotension, bradycardia, itching, drowsiness, nausea and vomiting.(24 hour period after suregry)
研究者
Dr Shruthi R
St. Johns Medical College Hospital