Chronic Pain, Laparoscopic Donor Nephrectomy, Living Kidney Donor, Quadratus Lumborum Block
Conditions
Brief summary
To analyze the relationship of anterior subcostal quadratus lumborum (QL) block compared with control block on the incidence of chronic neuropathic pain at three months post-laparoscopic retroperitoneal living kidney donor.
Interventions
Injection of 30 mL local anesthetic solution bupivacaine 0.25%
Injection of 30 mL normal saline Natrium Chloride (NaCl) 0.9%
Sponsors
Indonesia University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
Living kidney donor candidate patients aged 18-65 years Patients with ASA physical status assessment 1-3 Patients are willing to be research subjects.
Exclusion criteria
* The patient was known to have a history of chronic non-cancer pain and cancer pain. The patient had a history of preoperative laparoscopic kidney donor surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Neuropathic Pain Incidence: Neuropathic Pain in 4 Questionnaire | 3 months after intervention | Pain that develops after a surgical procedure in the area of surgery and its radiation, persists for at least 3 months after surgery, other causes of pain (e.g. infection and history of malignancy) or pre-existing pain have been excluded. Total score: 10 Score ≤ 4 = no pain developed Score ≥ 4 = pain developed |
| Neuromodulation Parameter: Degree of functional interference using Behavioral Pain Interference (BPI) | At 3 months after intervention | The degree of pain that develops after a surgical procedure in the area of surgery and its radiation, persisting for at least 3 months after surgery, other causes of pain (eg infection and history of malignancy) or pre-existing pain have been excluded. Behavioral Pain Interference (BPI) questionnaire based on the average of questions 4, 5, and 6 1. Mild (NRS 1-3) 2. Moderate (NRS 4-6) 3. Severe (NRS 7-10) |
| Chronic Pain Severity: Leeds Assesment of neuropathic symptoms and sign (LANSS) scale | At 3 months after intervention | A measuring tool used to assess neuropathic pain and provides information to differentiate nociceptive pain from neuropathic pain. Total score: 24 \<12: Not neuropathic \>12: Neuropathic pain |
| Neuroinflammation Parameter: Serum Concentration of Toll-like Receptor 4 (TLR4) | At 3 months after intervention | Transmembrane receptors in the innate immune system. Units: ng/mL |
| Neuroinflammation Parameter: Serum Concentration of Calcitonin gene-related peptide (CGRP) | At 3 months after intervention | Neuropeptides that play a role in pain transmission and vasodilation Unit: pg/mL |
| Neuroinflammation Parameter: Serum Concentration of Nerve Growth Factor (NGF) | At 3 months after intervention | Neurotrophic factors that play a role in promoting the growth and survival of sensory neurons Unit: pg/mL |
| Neurophysiology Parameter: Mechanical Detection Threshold (MDt) | At 3 months after intervention | Measures the minimum force needed for a person to perceive a light mechanical stimulus, tested using von Frey filaments. Skin contact test for 2 seconds using 1 set of von Frey filaments. The examination is performed in m. trapezius. Unit: mN Lower result means: higher sensitivity (normal or hypersensitivity) Higher result means: Reduced sensitivity, could indicate hypoesthesia or nerve damage |
| Neurophysiology: Mechanical Pain Threshold (MPt) | At 3 months after intervention | Accurate measurement of pain threshold. Skin contact test using repeated pinpricks at the same location. Comparative assessment of initial pain scale with pain scale after repeated stimulation. Examination is performed at m. trapezius. Unit: Numerical Rating Scale (NRS) from 1 to 10 Lower NRS: higher sensitivity to pain Higher NRS: lower sensitivity to pain |
| Neurophysiology Parameter: Pressure Pain Threshold (PPt) | At 3 months after intervention | Pain tolerance examination. Pressure assessment in kgf/cm2 units where the patient complains of pain according to the stimulus given. The examination is carried out in m. trapezius Units: kgf/cm2. Lower PPT: Increased pain sensitivity Higher PPT: Decreased pain sensitivity |
| Neurophysiology Parameter: Mechanical Temporal Summation of Pain (MTSP) | At 3 months after intervention | Evaluates central sensitization by applying repeated light mechanical stimuli and rating how pain builds up over time. Pressure assessment in kgf/cm2 units where the patient complains of pain according to the stimulus given. The examination is carried out in m. trapezius. Units: Verbal Numeric Scale (VNS) from 1 to 10 Higher MTSP score: Indicates central sensitization Lower MTSP score: Normal pain processing |
| Neuromodulation Parameter: Serum Concentration of beta-Endorfin | At 3 months after intervention | Neuropeptide produced in the anterior pituitary and brain, as an endogenous opioid. Units: pg/mL |
Countries
Indonesia
Outcome results
None listed