External Oblique and Rectus Abdominis Plane Block, Laparoscopic Cholecystectomy, Postoperative Analgesia, Quadratus Lumborum Block
Conditions
Brief summary
This study aims to compare the effects of the external oblique and rectus abdominis plane (EXORA) block and the quadratus lumborum block (QLB) on postoperative analgesia in patients undergoing laparoscopic cholecystectomy (LC).
Detailed description
Laparoscopic cholecystectomy (LC) is a proven, gold standard surgical procedure for the management of gallbladder stones. The quadratus lumborum block (QLB) is a regional block that would appear to be similar to the posterior TAP block, although the drug injection area is deeper and more dorsal than the transverse abdominal aponeurosis. The external oblique and rectus abdominis plane (EXORA) block is an emerging technique providing a sensory block to the anterolateral abdominal wall.
Interventions
OTHERExternal oblique and rectus abdominis plane block
Patients will receive an external oblique and rectus abdominis plane (EXORA) block using 20ml of bupivacaine 0.25%.
OTHERQuadratus lumborum block
Patients will receive a quadratus lumborum block (QLB) using 20ml of bupivacaine 0.25%.
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age from 18 to 65 years. * Both sexes. * American Society of Anesthesiology (ASA) physical status I-II. * Undergoing laparoscopic cholecystectomy (LC) under general anesthesia.
Exclusion criteria
* History of allergies to local anesthetics. * Opioid dependency. * Bleeding or coagulation disorders. * Psychiatric and neurological disorder. * Local infection at the site of injection. * Body mass index (BMI) \> 35. * Hypertension. * Uncontrolled diabetes mellitus.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to the 1st rescue analgesia | 24 hours postoperatively | Time to the first request for the rescue analgesia (time from the end of surgery to first dose of morphine administrated). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total morphine consumption | 24 hours postoperatively | Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the NRS \< 4. |
| Intraoperative fentanyl consumption | Intraoperatively | Additional fentanyl bolus dosages of 0.5 µg/kg IV will be administered if heart rate or mean arterial blood pressure elevated more than 20% of the baseline (after exclusion of other causes than pain). |
| Degree of pain | 24 hours postoperatively | Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at PACU, 2, 4, 6, 8, 12, 18 and 24 h postoperatively. |
| Incidence of adverse events | 24 hours postoperatively | Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, pruritus, or any other complication. |
Countries
Egypt
Outcome results
None listed