Comparison of the Effects of Anterior Quadratus Lumborum Block and Erector Spina Plane Block on Postoperative Acute Pain in Percutaneous Nephrolithotomy Surgery
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 90
- 试验地点
- 1
- 主要终点
- Morphine consumption in the first 24 hours after surgery
研究概览
简要总结
In this study, it was aimed to evaluate the effects of anterior quadratus lumborum block (QLB3) and Erector Spina Plane Block (ESPB) on postoperative acute pain scores and opioid consumption in the first 24 hours in Percutaneous Nephrolithotomy Surgery
详细描述
Percutaneous nephrolithotomy (PCNL) is commonly used to treat large kidney stones. Patients usually complain of severe pain and discomfort postoperatively. Postoperative pain prolongs hospital stay, delays wound healing, increases infection rates, and increases the incidence of drug side effects.
Regional anesthesia is part of multimodal analgesia in treating postoperative pain. Facial plane blocks are among these procedures. Erector spina plane block (ESPB) is a peri-paravertebral regional anesthesia technique applied for the first time to treat thoracic neuropathic pain. In the literature, the effectiveness of upper abdomen and renal operations in pain management has been demonstrated. Quadratus lumborum block (QLB) was first described as an alternative to the transversus abdominis plane block. This block can be performed with three methods under ultrasound guidance. An anterior QLB (QLB3) block was used in this study. In this block, the local anesthetic drug is applied between the quadratus lumborum muscle and the psoas muscle fascia and spreads along the thoracolumbar fascia. This block provides anesthesia and analgesia in the T7-L1 dermatome area. QLB3 block has been applied in pyeloplasty, cholecystectomy, lower abdominal surgeries, cesarean sections, radical nephrectomy, and hip joint surgeries and provided adequate postoperative analgesia.
This study aimed to evaluate the effects of QLB3 block and ESPB block on pain scores and opioid consumption in patients undergoing PCNL.
Patients will be divided into three groups.
Group QLB3:
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •18-65 years
- •American Society of Anesthesiology score I-III patients scheduled for unilateral PCNL in elective conditions
- •Patients with BMI <35 kg/m2
排除标准
- •Pregnancy
- •Conditions where regional anesthesia is contraindicated (coagulopathy, international normalized ratio abnormality, thrombocytopenia, infection at the injection site)
- •History of hypersensitivity or allergy to local anesthetics
- •Patients with psychiatric disorders
- •Patients with musculoskeletal deformities
- •Patients with alcohol-drug dependence
- •Patients with cognitive dysfunction (patients incapable of evaluating the NRS score)
- •Patients who did not give consent / did not want to participate
结局指标
主要结局
Morphine consumption in the first 24 hours after surgery
时间窗: postoperative day 1
Morphine consumption in the first 24 hours after surgery will be measured. Patients will be able to request opioids via a PCA device when their NRS score is ≥ 4.
次要结局
- Postoperative pain scores(postoperative day 1)
- Intraoperative remifentanil consumption(The remifentanil consumption will be recorded from anesthesia induction until the patient is referred to the recovery unit, up to 150 minutes.)
- The number of patient required rescue analgesia(postoperative day 1)
- The mean arterial pressure(The mean arterial pressure was recorded preoperatively, one minute after the induction, and every 15-30 minutes until the patient was referred to the recovery unit, up to 180 minutes.)
- The heart rate measurement(The heart rate was recorded preoperatively, one minute after the induction, and every 15-30 minutes until the patient was referred to the recovery unit, up to 180 minutes.)
- The postoperative nausea and vomiting (PONV) scores and the number of patients requiring antiemetic medication.(postoperative day 1)
- Time of first analgesic request(postoperative day 1)
- The number of patients with complications(Postoperative 7 days on an average)
研究者
Cengiz KAYA
Principal Investigator, Clinical Professor
Ondokuz Mayıs University