Postoperative Pain
Conditions
Brief summary
This is a randomised controlled trial which will compare the Quadratus Lumborum (QL) Block with the Transversus Abdominis Plane (TAP) Block in terms of analgesic efficacy, ease of performance and safety when administered postoperatively in patients who undergo laparoscopic nephrectomy. To fulfill this purpose, three groups of patients each with 32 patients, will be formed. Patients in the Transversus Abdominis Plane (TAP) group and Quadratus Lumborum (QL) group will each receive the respective blocks with 0.4 ml/kg of 0.25% Bupivacaine, after completion of surgery. The third (Control group) will not receive any blocks. After shifting patients to recovery all three groups will be put into intravenous patient controlled analgesia (PCA) Morphine as rescue analgesic regimen as per a set protocol. Morphine consumption over the first postoperative 24 hours, ease of performance of individual blocks and associated adverse events, adverse events associated with opioid use, patient recovery and satisfaction will be noted.
Interventions
OTHERTransversus Abdominis Plane (TAP) Block
0.5 ml/kg of 0.25 % Bupivacaine deposited in the transversus abdominis plane under ultrasound guidance postoperatively
0.5 ml/kg of 0.25 % Bupivacaine deposited in the anterolateral aspect of the quadratus lumborum muscle under ultrasound guidance postoperatively
Sponsors
Post Graduate Institute of Medical Education and Research, Chandigarh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* patients between 18-65 years of age, * ASA class I or II, * undergoing elective unilateral laparoscopic nephrectomy * under general anaesthesia
Exclusion criteria
Patients with any of the following: * refusal to participate in the study * coagulopathy/ thrombocytopenia * localised infection at the proposed site of injection * inability to comprehend the scoring systems to be employed or use PCA due to physical or mental problems * known allergy to the drugs to be used (local anesthetics, opioids) * opioid tolerance/ dependence * renal impairment * hepatic impairment * known cardio-respiratory impairment * morbid obesity/ sleep apnoea
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Cumulative morphine consumption in 24 hours in milligrams | within the first 24 hours after surgery |
Secondary
| Measure | Time frame |
|---|---|
| Ease of performing the respective blocks (assessed by time required to perform the blocks in minutes and number of attempts required to perform the blocks) | while performing block |
| Pain scores at rest and on movement as measured by numeric rating scale (0 to 10) | within the first 24 hours after surgery |
| Incidence of block related complications | within the first 24 hours after surgery |
| Incidence of adverse effects related to opioid use (derrived from incidence of nausea and vomiting, sedation and respiratory depression) | within the first 24 hours after surgery |
| Patient satisfaction as measured by numeric rating scale (0 to 10) | 24 hours after surgery |
| Time to first demand of rescue analgesic in hours | within the first 24 hours after surgery |
Countries
India
Outcome results
None listed