Comparison of unilateral versus bilateral Quadratus Lumborum Block using Bupivacaine with Dexmedetomidine for Postoperative Analgesia in Laparoscopic Nephrectomies: A randomized study.
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 120
- 试验地点
- 1
- 主要终点
- To compare postoperative Numeric rating Scale (NRS) scores over 24 hours.
研究概览
简要总结
Effective pain management after Laparoscopic Nephrectomy is of pivotal for postoperative recovery and patient satisfaction. Various regional blocks like Quadratus Lumborum Block (QLB), Erector Spinae Plane Block (ESPB), and Transverse Abdominis Plane (TAP) Block have been used in nephrectomies. Among the facial plane blocks, QLB effectively decreases opioid requirements, pain scores, and associated side effects in patients undergoing nephrectomy [1].
Both unilateral and bilateral QLBs were used for analgesia, but still not compared for analgesic effect. Preoperative unilateral QLB in laparoscopic-assisted nephrectomy successfully decreased postoperative pain and perioperative opioid consumption [2]. Bilateral QLB techniques showed comparable postoperative analgesic properties with epidural among living kidney donors undergoing laparoscopic nephrectomy [3-4]. So, we have planned this study to compare the unilateral vs bilateral QLB using Bupivacaine with Dexmedetomidine in laparoscopic nephrectomies.
References:
1. Little C, Rahman S. Quadratus Lumborum Blocks in Nephrectomy: A Narrative Review. Local Reg Anesth. 2021 Apr 19;14:57-65.
2. Li Y, Wang L, Sun J, Xie T, Fu J, Feng C, Lu G. Effects of Subcostal Anterior Quadratus Lumborum Block with and without Dexmedetomidine on Postoperative Rehabilitation in Patients Undergoing Laparoscopic Renal Surgery: A Prospective Double-Blinded Randomized Controlled Study. Drug Des Devel Ther. 2023 Nov 10;17:3281-3293.
3. Rahendra R, Pryambodho P, Aditianingsih D, Sukmono RB, Tantri A, Melati AC. Comparison of IL-6 and CRP Concentration Between Quadratus Lumborum and Epidural Blockade Among Living Kidney Donors: A Randomized Controlled Trial. Anesth Pain Med. 2019 Apr 28;9(2): e91527.
4. Aditianingsih D, Pryambodho, Anasy N, Tantri AR, Mochtar CA. A randomized controlled trial on analgesic effect of repeated Quadratus Lumborum block versus continuous epidural analgesia following laparoscopic nephrectomy. BMC Anesthesiol. 2019 Dec 5;19(1):221. doi: 10.1186/s12871-019-0891-7. PMID: 31805855; PMCID: PMC6894195.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 盲法
- Participant and Outcome Assessor Blinded
入排标准
- 年龄范围
- 18.00 Year(s) 至 75.00 Year(s)（—）
- 性别
- All
入选标准
- •ASA I/II, 18-75 years male &female patients planned for laparoscopic nephrectomy surgery.
排除标准
- •Patients with known allergy to the drugs used Patients with contraindications for QLB Patient refusal for consent BMI more than 35.
结局指标
主要结局
To compare postoperative Numeric rating Scale (NRS) scores over 24 hours.
时间窗: To compare postoperative Numeric rating Scale (NRS) scores over 24 hours.
次要结局
- a) Time to request of first rescue analgesia and number of doses(b) Total dose of Intraoperative Opioid used)
研究者
Dr Neha Singh
All India Institute of Medical Sciences, Bhubaneswar