Postoperative Pain
Conditions
Keywords
postoperative pain, Laparoscopic cholecystectomy, Quadratus lumborum block, transversus abdominis plan block
Brief summary
In this study, investigators aimed to compare the Quadratus Lumborum Block and the Transversus Abdominis Plan Block for postoperative pain control after laparoscopic cholecystectomy
Detailed description
After ethical committee approval, informed written consent will be obtained from all patients. A Sample size of 60 patients (30 per group) was calculated based on 15% reduction in morphine consumption with 0.05% significance and a power of 0.8. Consenting patients scheduled to have elective laparoscopic cholecystectomy under general anesthesia will be randomized to receive bilateral QLB or TAP before the surgery. The dose of local anesthetic in both groups will be 20 ml 0.25% Bupivacaine. Allocation to either group will be done using permuted block randomization method. Patients will be taken to the block room 1 hour before surgery. ECG, NIBP and SpO2 monitor will be done. The IV access route will be provided. The patient will be given 0.03 mg / kg IV midazolam for routine premedication. Block will be applied by a blind anesthetist to the other data of the study. Under ultrasound guidance a 22 Gauge Sonoplex needle will be used for both techniques. The calculated dose of local anesthetic will be injected bilaterally with intermittent aspiration. The spread of injectate will be seed on ultrasound. The procedure time for both blocks will be recorded and 30 minutes after the procedure is completed, and the patient will be taken to the operation room. General anesthesia will be applied to the patient in the operation procedure in the standard procedure. Intraoperative heart rate and / or mean arterial pressure is increased to 20% of the basal value and 0.5 mcg / kg IV fentanyl will be added. 30 minutes before the end of operation, 1 mg IV paracetamol and NSAID (dexketoprofen) 50 mg IV will be administered to the patient before extubation. The patient will be infected with IV PCA in the morphine. PC 1 mg IV bolus dose will be adjusted to 10 minutes of locked-out period. In the postoperative period, 4 \* 1 gr / 24 h IV paracetamol will be given to each patient. All patients will be assessed postoperatively by a blinded investigator: in the post-anesthesia care unit and at 0, 2, 4, 6, 12 and 24 h postoperatively.
Interventions
PROCEDUREquadratus lumborum block
QLB: Quadratus lumborum block : 20 mL of 0.25% bupivacaine will be administered between the quadratus lumborum and the psoas major muscle bilaterally in the lateral decubitus position
PROCEDURETransversus abdominis plan block
TAP: transversus abdominis plan block: 20 mL of 0.25% bupivacaine will be administered between the internal oblique muscle and the transversus abdominis muscle bilaterally in the supine position
Sponsors
Kecioren Education and Training Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Masking description
Double-blind randomized controlled trail
Intervention model description
Double-blind randomized controlled trail
Eligibility
Sex/Gender
ALL
Age
19 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* ASA 1-2-3 * elective Laparoscopic cholecystectomy * 19-65 years * Written informed consent
Exclusion criteria
* Patient refusal Local infection at the site of injection * Allergy to study medications Sepsis Anatomic abnormalities Systemic anticoagulation or coagulopathy - Inability to comprehend or participate in pain scoring system * Inability to use intravenous patient controlled analgesia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total cumulative morphine consumption | 24 hour | Total cumulative morphine dose in mg used in the first 24 hours after surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Severity of postoperative pain via visual analogue pain scale (VAS) | 24 hour | VAS range from 0 for no pain to 10 for worst pain imaginable |
| Nausea or vomiting | 24 hour | 0 = No Nausea 1. = Mild Nausea. 2. = Moderate 3 = Severe Nausea or Vomiting |
Countries
Turkey (Türkiye)
Contacts
Primary Contactmerve kacan
Outcome results
None listed