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Quadratus Luborum Block Using Bupivacaine Versus Bupivacaine-Dexamethasone in Laparoscopic Cholecystectomy

Not Applicable
Completed
Conditions
Post Operative Pain
Interventions
Drug: TQL block with saline
Drug: TQL block with Bupivacaine
Registration Number
NCT03956966
Lead Sponsor
Minia University
Brief Summary

The aim of the present study was to compare the effectiveness of transmuscular Quadratus Lumborum block using Bupivacaine versus Bupivacaine- Dexamethasone in providing analgesia in patients undergoing laparoscopic cholecystectomy.

Because postoperative pain after laparoscopic surgery is complex, specialists suggest that effective analgesic treatment should be a multimodal support. Quadratus lumborum block (QLB) is a new abdominal truncal block for controlling somatic pain in both the upper and lower abdomen. Dexamethasone, through its anti-inflammatory and blocking effects on neural discharge, and nociceptor C fibers transmission could be used as a local anesthetic adjuvant.

Detailed Description

The patients were randomly allocated into three groups each contains (30) patient. Control group (C) received bilateral ultrasound guided quadratus lumborum block using (20 ml 0.9% normal saline + 1mL 0.9% normal saline) in each side ,Bupivacaine group (B) received bilateral quadratus lumborum block using (20 ml Bupivacaine hydrochloride 0.25% + 1mL 0.9% normal saline) in each side and Dexamethasone-Bupivacaine group (D) received bilateral quadratus lumborum block using (20 ml Bupivacaine hydrochloride 0.25% + 1 mL dexamethasone "4mg") in each side.

The following variables: heart Rate, mean arterial Blood Pressure, peripheral oxygen saturation, visual analogue pain scale , time to first analgesic request, total Analgesic requirement in the first 24 hours, patient satisfaction and complications were Recorded and compared between groups.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
90
Inclusion Criteria
  • American Physical Status I or II
  • Elective laparoscopic Cholecystectomy
Exclusion Criteria
  • Patient refusal.
  • Hematological diseases
  • Bleeding disorders.
  • Coagulation abnormality.
  • Psychiatric diseases.
  • Local skin infection
  • Sepsis at site of the block.
  • Known intolerance to the study drugs.
  • Body Mass Index > 40 Kg/m2.
  • Emergency laparoscopic cholecystectomy
  • If laparoscopic procedure converted to open.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Bupivacaine and dexamethasoneTQL block with Bupivacaine and dexamethasonebilateral quadratus lumborum block using Bupivacaine hydrochloride 0.25% and dexamethasone
salineTQL block with salinebilateral quadratus lumborum block using 0.9% normal saline
BupivacaineTQL block with Bupivacainebilateral quadratus lumborum block using Bupivacaine hydrochloride 0.25%
Primary Outcome Measures
NameTimeMethod
Time for first request to rescue analgesia24 hours

Time for the first request to rescue analgesia (in minutes)

Secondary Outcome Measures
NameTimeMethod
intraoperative fentanylFor 4 hours after start of anaesthesia

Cumulative intraoperative fentanyl consumption (total dose given in micrograms)

side effectsFor 24 hours after surgery

Incidence of postoperative nausea and vomiting

postoperative Nalbuphine24 hours after surgery

Cumulative postoperative Nalbuphine consumption (total dose given in milligrams)

Postoperative pain severity will be assessed using VAPSFor 24 hours after surgery

The severity of postoperative pain will be measured and recorded by using the visual analogue scale (VAPS) for pain, where 0 is equal to no pain and 10 indicates the worst possible pain

Trial Locations

Locations (1)

Minya University

🇪🇬

Minya, Egypt

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