Ultrasound-guided Quadratus Luborum Block Using Bupivacaine Versus Bupivacaine-Dexamethasone for Postoperative Analgesia in Laparoscopic Cholecystectomy
Overview
- Phase
- Not Applicable
- Intervention
- TQL block with saline
- Conditions
- Post Operative Pain
- Sponsor
- Minia University
- Enrollment
- 90
- Locations
- 1
- Primary Endpoint
- Time for first request to rescue analgesia
- Status
- Completed
- Last Updated
- 2 years ago
Overview
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.
Investigators
haidy salah mansour
principle investigator
Minia University
Eligibility Criteria
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/m
- •Emergency laparoscopic cholecystectomy
Arms & Interventions
saline
bilateral quadratus lumborum block using 0.9% normal saline
Intervention: TQL block with saline
Bupivacaine
bilateral quadratus lumborum block using Bupivacaine hydrochloride 0.25%
Intervention: TQL block with Bupivacaine
Bupivacaine and dexamethasone
bilateral quadratus lumborum block using Bupivacaine hydrochloride 0.25% and dexamethasone
Intervention: TQL block with Bupivacaine and dexamethasone
Outcomes
Primary Outcomes
Time for first request to rescue analgesia
Time Frame: 24 hours
Time for the first request to rescue analgesia (in minutes)
Secondary Outcomes
- intraoperative fentanyl(For 4 hours after start of anaesthesia)
- side effects(For 24 hours after surgery)
- postoperative Nalbuphine(24 hours after surgery)
- Postoperative pain severity will be assessed using VAPS(For 24 hours after surgery)