Postoperative Pain, Ultrasound Guided Transmuscular Quadratus Lumborum Block
Conditions
Brief summary
Patients with kidney cancer often undergo hand-assisted laparoscopic nephrectomy or Robot assisted partiel nephrectomy. The investigators performed a one-year retrospective study. the sudy revealed that 67% of the patients needed substantial amounts of opioids for postoperative pain management (PPM) in recovery despite a multimodal analgesic regime. In a prospective pilot study including ten laparoscopic hand-assisted nephrectomy, with severe postoperative pain the investigators found that bilateral Ultrasound-guided (USG) transmuscular quadratus lumborum (TQL) block substantially reduced pain and opioid consumption. This study aims to evaluate the effect on PPM of a bilateral USG TQL block compared to placebo.
Interventions
DRUGRopivacaine
Single shot of ropivacaine 0.325%
DRUGSaline
Single shot of saline 0.9%
Sponsors
Zealand University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Masking description
Double blind
Intervention model description
Double blind placebo Controlled Trial
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* over 18 years * Kidney cancer * Have received thorough information, orally and in written * Signed the Informed Consent form on participation in the trial
Exclusion criteria
* Inability to cooperate * Inability to speak and understand Danish both orally and written * Allergy to local anaesthetics or opioids * Daily intake of opioids * Local infection at the site of injection or systemic infection * Difficulty visualisation of muscular and fascial structures in ultrasound visualisation necessary to the block administration * Known abuse of alcohol or medicine * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| opioid consumption | 12 hours postoperatively | Opioid consumption postoperatively: data from Patient Controlled Analgesia(PCA) pump and patient medical record). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| NRS score | 12 hours postoperatively | Numeric Rating Scale(NRS). Scores range from 0-10, 0=no pain-10=worst pain postoperatively at rest and activity |
| NRS score at rest and activity | 6 hours postoperatively | Numeric Rating Scale(NRS). Scores range from 0-10, 0=no pain-10=worst pain |
| opioid consumption | 6 hours postoperatively | Opioid consumption postoperatively (data from PCA pump and patient medical record). |
| Patient satisfaction with application of the block. NRS | Immediately after application of the block | Numeric Rating Scale(NRS). Scores range from 0-10, 0=no pain-10=worst pain |
| Ambulation | within 24 hours postoperatively | Time from operation to ambulation |
| Opioid-related side effects | 6 hours postoperatively | The degree of morphine-related side effects (PONV, itching, fatigue, etc.) |
Countries
Denmark
Outcome results
None listed