Post Operative Pain
Conditions
Keywords
bupivacaine, dexamethasone, quadratus lumborum block
Brief summary
The objective of this study is to assess the analgesic sparing effect of adding Dexamethasone to Bupivacaine in Quadratus lumborum block in patients undergoing Laparoscopic cholecystectomy under general anesthesia.
Detailed description
Background: The QLB is an effective analgesic technique for various abdominal wall incisions. The QLB covers T7 to L2 dermatomes by the spread of LA drugs either into the paravertebral space or in the thoracolumbar plane, through iliohypogastric and ilioinguinal nerves, A and C fiber nociceptors, mechanoreceptors and high-density network of lumbar sympathetic fibers. Objective: To assess the analgesic sparing effect of adding Dexamethasone to Bupivacaine in Quadratus lumborum block in patients undergoing Laparoscopic cholecystectomy under general anesthesia. Patients and Methods: Sixty patients scheduled for elective Laparoscopic cholecystectomy surgeries under general anesthesia were included in this study, they were divided into two groups. Group A (perineural dexamethasone and bupivacaine group) \[n=30\] Those cases will receive 2ml volume of dexamethasone (8mg) combined with 18 ml of bupivacaine of 0.25% concentration. Group B (perineural bupivacaine group) \[n=30\] Those cases will receive perineural 18 ml bupivacaine (0.25%) combined with 2 ml normal saline.
Interventions
DRUGBupivacaine
18 ml of bupivacaine of 0.25% injected bilaterally in quadratus lumborum block
DRUGDexamethasone
dexamethasone
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
1. Adult patients aging \> 18 years of both sexes. 2. Patients undergoing Laparoscopic cholecystectomy surgeries (duration of operation 50-80 minutes). 3. ASA physical status classes I - II.
Exclusion criteria
1. Patient's refusal of procedure or participation in the study. 2. ASA classes III or above. 3. Coagulopathy and bleeding disorders. 4. Local skin infections 5. Body mass index \>40kg/m2
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| measuring the time interval required till the first analgesic dose | the first 24 hours | to reach a numeric rating scale NRS Pain score ≥4 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| total pethidine dose received | total pethidine dose received in 24 hours | record total dose of pethidine |
| mean blood pressure | will be recorded 5 minutes before injection, 5 minutes after injection then every 20 minutes intra-operatively and at intervals of 1, 2, 4, 6, 12, 18 and 24 hours postoperatively. | hemodynamics |
| heart rate changes | will be recorded 5 minutes before injection, 5 minutes after injection then every 20 minutes intra-operatively and at intervals of 1, 2, 4, 6, 12, 18 and 24 hours postoperatively. | hemodynamics |
| Incidence of side effects | record any side effect over 24 hours | occurrence of nausea and vomiting |
Countries
Egypt
Outcome results
None listed