None listed
Conditions
Brief summary
Multimodal analgesia aims to reduce the side effects of each treatment modality while providing effective and comprehensive pain management by targeting various mechanisms of pain. Fascial plane blocks, whose application frequency has been increasing recently; It plays an important role in postoperative analgesia by ensuring direct and specific optimization of pain control, less opioid use and reduction of opioid-related side effects (e.g. nausea, vomiting, respiratory depression). The effects of the quadratus lumborum block, which is one of the fascial plane blocks and is known to provide effective analgesia after surgical procedures, especially in the lower abdomen and pelvis, are open to research due to its different approaches and application methods. Quadratus lumborum block provides effective analgesia in TUR-M cases, reducing postoperative opioid consumption. Anterior quadratus lumborum block may be a better choice than the posterior approach as it may spread more and faster to the paravertebral area.
Interventions
In this study, 105 patients undergoing elective transurethral bladder tumor resection under spinal anesthesia will be randomly assigned to 3 groups. Group A will be received ultrasound-guided anterior quadratus lumborum block (QLB) where the local anesthetic is injected anterior to the QL muscle with 0.25% 20 mL bupivacaine each side and group B will be received ultrasound-guided posterior QLB where the local anesthetic is injected posterior to the QL muscle with 0.25% 20 mL bupivacaine each si
In this study, 105 patients undergoing elective transurethral bladder tumor resection under spinal anesthesia will be randomly assigned to 3 groups. Group A will be received ultrasound-guided anterior quadratus lumborum block (QLB) where the local anesthetic is injected anterior to the QL muscle with 0.25% 20 mL bupivacaine each side and group B will be received ultrasound-guided posterior QLB where the local anesthetic is injected posterior to the QL muscle with 0.25% 20 mL bupivacaine each side by one of two experienced anesthesiologists who will not participate in the rest of the study. Group C will be received a placebo. Local anesthetic doses are determined by the anesthesiologist performing the procedure in accordance with clinical studies in the literature. All injection procedures will be performed once as soon as the surgery is completed. Patients will be monitored by the nurse and doctor in the 24-hour period after the procedure and the parameters will be noted for evaluation. The block procedures mentioned above and postoperative pain monitoring are routine procedures, and medical records will be reviewed in the study. The investigator will not be involved in patient care, preoperative evaluation, or data collection but will use a random sequence of numbers to randomize patients.
Sponsors
Health Sciences Istanbul Training and Research Hospital
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
20 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
Patients who are aged between 20 to 75 years with a body mass index (BMI) of 20-30 kg/m2, who are included in the American Society of Anesthesiologists Physical Status I-II-III classes will be scheduled elective transurethral bladder tumor resection under spinal anesthesia.
Exclusion criteria
Patients with coagulation abnormalities, local anesthetic allergy, systemic or puncture site infections, alcohol and drug addictions, inability to accurately cooperate in pain assessments due to cognitive dysfunction, liver or kidney failure and persistent pain more than 3 months will be excluded from the study.
Outcome results
None listed