Ultra-sound Guided Bilateral Quadratus Lumborum Block Versus Epidural Block for Postoperative Analgesia After Major Abdominal Surgeries.
Overview
- Phase
- Not Applicable
- Intervention
- Thoracic epidural block
- Conditions
- Elective Major Abdominal Surgery
- Sponsor
- Mansoura University
- Enrollment
- 80
- Locations
- 1
- Primary Endpoint
- Postoperative 24 hours cumulative rescue morphine consumption
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
Acute postoperative pain is an important issue after major abdominal surgeries for which different analgesic modalities have been tried.
Epidural analgesia is the recommended technique to relieve pain after major abdominal surgeries owing to the proved superior analgesia, reduction of opioid-related side effects as nausea, vomiting, pruritis and sedation, earlier recovery of bowel function and earlier ability for postoperative mobility. However, it is not without complications.
Quadratus lumborum block is an ultrasound-guided block that provides patients with both visceral and somatic blockade. It lessens the potential risks associated with neuraxial techniques, so it may represent a novel alternative approach for analgesia after major abdominal surgeries.
Detailed Description
The aim of this study is to detect the feasibility of ultra-sound guided bilateral quadratus lumborum block as a postoperative analgesic modality after major abdominal surgery in comparison to epidural block and its effects on total rescue analgesic requirements in the 1st postoperative 24hours, time to first analgesic request, pain VAS scores, intraoperative and postoperative hemodynamics and postoperative opioid-related side effects. Under complete aseptic conditions, the patients will receive either thoracic epidural block or bilateral ultrasound-guided quadratus lumborum block after induction of general anaesthesia
Investigators
Eligibility Criteria
Inclusion Criteria
- •American Society of Anesthesiologists (ASA) physical status I-III
Exclusion Criteria
- •Patient's refusal
- •Significant cardiac, disease.
- •Significant hepatic disease.
- •Significant renal disease (serum creatinine ˃ 1.5 mg/dl).
- •Patients with drug abuse
- •Allergy to study medications
- •Mental disease
- •Communication barrier.
- •Coagulopathy.
- •Local skin infection
Arms & Interventions
Thoracic epidural block
Patients will receive thoracic epidural block following induction of general anaesthesia
Intervention: Thoracic epidural block
Thoracic epidural block
Patients will receive thoracic epidural block following induction of general anaesthesia
Intervention: Induction of general anaesthesia with propofol
Thoracic epidural block
Patients will receive thoracic epidural block following induction of general anaesthesia
Intervention: Muscle Relaxant
Thoracic epidural block
Patients will receive thoracic epidural block following induction of general anaesthesia
Intervention: Maintenance of general anaesthesia
Bilateral quadratus lumborum block
Patients will receive Ultrasound-guided bilateral quadratus lumborum block following induction of general anaesthesia
Intervention: Ultrasound-guided bilateral quadratus lumborum block
Bilateral quadratus lumborum block
Patients will receive Ultrasound-guided bilateral quadratus lumborum block following induction of general anaesthesia
Intervention: Induction of general anaesthesia with propofol
Bilateral quadratus lumborum block
Patients will receive Ultrasound-guided bilateral quadratus lumborum block following induction of general anaesthesia
Intervention: Muscle Relaxant
Bilateral quadratus lumborum block
Patients will receive Ultrasound-guided bilateral quadratus lumborum block following induction of general anaesthesia
Intervention: Maintenance of general anaesthesia
Outcomes
Primary Outcomes
Postoperative 24 hours cumulative rescue morphine consumption
Time Frame: For 24 hours after surgery
Secondary Outcomes
- The duration of postoperative analgesia(For 24 hours after surgery)
- Postoperative pain score at rest(For 24 hours after surgery)
- Systolic blood pressure(For 28 hours after induction of anesthesia)
- Postoperative pain score on movement(For 24 hours after surgery)
- Heart rate(For 28 hours after induction of anesthesia)
- Degree of postoperative nausea and vomiting(For 24 hours after surgery)
- Pruritis(For 24 hours after surgery)
- Postoperative pain score on cough(For 24 hours after surgery)
- Diastolic blood pressure(For 28 hours after induction of anesthesia)
- Mean blood pressure(For 28 hours after induction of anesthesia)