Preoperative Versus Postoperative Ultrasound Guided Quadratous Lunborum Block for Postoperative Analgesia Following Open Nephrectomy, Acomparative Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Regional Blocks
- Sponsor
- Ain Shams University
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- The time to first postoperative rescue analgesia.
- Status
- Not yet recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
A multimodal analgesia regimen is suggested after nephrectomy, although some patients still report agonising pain. Regional anesthesia approaches may improve postoperative pain management and reduce the requirement for opioids after renal surgery.QLB provides early and rapid pain relief
Detailed Description
In the immediate postoperative period, nerve blocks are considered a type of multimodal analgesia and have recently been proposed as analgesic options for patients undergoing open nephrectomy . Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. The main barrier to early postoperative ambulation is postoperative pain, which also lengthens hospital stays and raises the risk of respiratory problems and venous thromboembolism. Therefore, strict perioperative pain management can have both immediate and long-term advantages . QLB provides early and rapid pain relief and allows early ambulation in certain patient populations. Multiple case studies also confirmed the QLB to be a rescue block after different surgical procedures. Complications associated with the performance of abdominal wall blocks are fortunately very rare. However, studies on the effect of anterior QLB on postoperative opioid consumption are scarce . Regional anesthesia is quickly moving toward using ultrasound guidance as the gold standard. The use of ultrasound has significant advantages over traditional treatments such as nerve stimulation and loss of resistance. The improved safety and efficacy that ultrasound brings to regional anaesthesia will help promote its use and realise the benefits that regional anaesthesia has over general anaesthesia, such as decreased morbidity and mortality, superior postoperative analgesia, cost-effectiveness, decreased postoperative complications and an improved postoperative course . The aim of the present study is to compare the effectiveness of ultrasound-guided preoperative to postoperative QLB on the postoperative pain scores after Radical nephrectomy.
Investigators
Sanaa Farag Mahmoud Wasfy
assistant professor of anesthesia and intensive care
Ain Shams University
Eligibility Criteria
Inclusion Criteria
- •o Patients aged between 18 - 60 years old.
- •Both sexes.
- •Physical Status: ASA I and II.
Exclusion Criteria
- •o Refusal of procedure or participation in the study .
- •Physical status: ASA III or above .
- •Infection at site of injection.
- •Psychiatric illness .
- •CNS Diseases like epilepsy, stroke ...etc.
- •History or evidence of coagulopathy .
- •Allergies to drug used (Bupivacaine 0.5%).
- •Patients who suffered from allergy to local anesthetics .
- •Difficult visualization of the anatomy.
Outcomes
Primary Outcomes
The time to first postoperative rescue analgesia.
Time Frame: postoperative 24 hours
the first time patient ask for analgesia
Secondary Outcomes
- total consumption of opioid in first 24 hours(first 24 hours postoperatively)