Comparison Between Ultrasound Guided Subcostal Oblique Quadratus Lumborum Block and Erector Spinae Plane Block in Patients Undergoing Percutaneous Nephrolithotomy
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 92
- 试验地点
- 1
- 主要终点
- Analgesia
研究概览
简要总结
comparing the subcostal oblique Quadratus Lumborum block and the Erector Spinae plane block in patients undergoing percutaneous nephrolithotomy operation to get the best and longest postoperative analgesic effect.
详细描述
Here the investigators are going to compare between the Anterior approach for the subcostal oblique Quadratus Lumborum block (QLB) and the Erector Spinae Plane Block (ESPB) to determine their level of spread and their value in controlling postoperative pain in patients scheduled for Percutaneous Nephrolithotomy surgery. We hypothesized that quadratus lumborum is not inferior regarding the duration of analgesia when compared to erector spinae in patients undergoing percutaneous nephrolithotomy under general anesthesia.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Age: 18-60
- •ASA (American Society of Anesthesiologists) class I and II
- •Elective surgery
- •Patients undergoing PNL surgery
排除标准
- •Patient's refusal
- •Allergy or contraindications to drugs used in the study
- •Emergency surgery
- •Psychiatric disorders
- •Severely co-morbid patients
- •Inflammation or infection over injection site
- •Bleeding diathesis; INR more than 1.5 and Platelet count less than 100,000/mm3
- •Peripheral neuropathy
- •Obese patients BMI ≥35
- •Patients on previous opioid therapy
- •Pre-operative haemoglobin <10 mg/dl
- •Inability to properly describe postoperative pain to investigators
- •Coagulation abnormalities
- •History of drug addiction or alcohol abuse
- •History of Previous renal surgery
研究组 & 干预措施
QLB
The patient is in the prone position, an ultrasound probe is placed in a transverse, oblique, and paramedian orientation approximately lateral to the posterior axillary line. The needle is then inserted in-plane from the medial side of the transducer and advanced laterally to enter the interfascial plane between the Quadratus Lumborum muscle and the kidney. We confirmed that the local anesthetic appeared to press down the kidney in the ultrasound image
干预措施: Subcostal Oblique Quadratus Lumborum Block and Erector Spinae Plain Block. (Procedure)
ESPB
Using aseptic technique, an ultrasound probe is placed at the T9 vertebral level. After identifying the ribs and sliding towards the midline in a longitudinal parasagittal orientation, the overlying Erector Spinae is identified by visualization of the transition between the rib and transverse apophysis a block needle is inserted in plane with ultrasound beam and is advanced in a cephalo-caudal direction until the tip contacted the transverse process.
干预措施: Subcostal Oblique Quadratus Lumborum Block and Erector Spinae Plain Block. (Procedure)
结局指标
主要结局
Analgesia
时间窗: 48 hours
Total opioid consumption during the first 48hours postoperatively.
次要结局
- time of recovery of bowl movement(5 days postoperative)
- postoperative length of hospital stay(within 2 weeks postoperative.)
- Pain Scores using Visual Analog Scale (VAS) Scores(24 hours postoperative.)
- ambulation time(5 days postoperative)
- Analgesia(24 hours)
- episodes of nausea and vomiting(within 24 hours postoperative)
- patient satisfaction with anesthesia(48 hours postoperative.)
研究者
Peter Bassem Halim Gadelsyed
Resident Doctor in Anesthesia, postoperative ICU and pain management department
Assiut University