Postoperative pain control in colorectal surgery is one of the key components for ERAS (Enhanced recovery after surgery) protocol. Inadequate pain control may also lead to postoperative complications such as pulmonary complications, myocardial infarction, ileus as well as transforming into persistent post surgical pain if not controlled. Quadratus Lumborum Block, Elective Open Colorectal Surgery, morphine consumption
Conditions
Interventions
In QL-group, the block will be performed while the patient is in supine position. A small wedge- shaped pillow will be placed bilaterally behind the patients hip to exposed the posterolateral part of
Experimental Procedure/Surgery,No Intervention No treatment
Posterior Quadratus Lumborum Block ,Control group
Sponsors
Department of Anesthesiology
Eligibility
Sex/Gender
All
Age
40 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Patients aged between 40-80 years 2. Bodyweight more than 45 kg 3. ASA physical status between I-III 4. Written informed consent obtained from the patients I appreciate participating in this study with the sign
Exclusion criteria
Exclusion criteria: 1. Adults who are unable to give their own consent 2. Pre-existing lower extremities weakness 3. Patient who shows sign of infection at the site of QLB 4. BMI more than 40 kg/m2 5. Allergy or contraindication to any drug used in this study 6. Coagulopathy (assessed by history and physical examination and, if deemed clinically necessary, by blood work up i.e. platelets less than and equal 100,000 cell/mm3, INR more than and equal 1.4) 7. Chronic pain syndromes requiring chronic opioid use 8. Inability to use IV PCA device 9. History of kidney impairment (estimated GFR less than 60 ml/min) 10. History of liver dysfunction (history of cirrhosis, portal hypertension, or variceal bleeding, AST, ALT more than and equal 50 IU/L) 11. Pregnancy 12. Refuse to participate or withdraw their consent at any stage of the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| cumulative morphine consumption during 24 h postoperatively at 24 hours after patient has arrived at recovery room quantitative measurement (mg) | — |
Secondary
| Measure | Time frame |
|---|---|
| cumulative morphine consumption at PACU, 6,12,48 h postoperatively at 48 hours after patient has arrived at recovery room quantitative measurement (mg),postoperative pain score using numerical rating scale (NRS) at rest and movement at different time point(PACU,6,12,24,48h) at 48 hours after patient has arrived at recovery room numerical rating scale,time until earliest single PCA dose of morphine at 48 hours after patient has arrived at recovery room Norminal scale,side effects associated with the block and morphine used (quadriceps weakness, hematoma, infection, LAST, PONV, itching, and respiratory depression) at 48 hours after patient has arrived at recovery room Norminal scale,quality of recovery after anesthesia measured with the Thai QoR-35 questionnaire at 48 hours after patient has arrived at recovery room ordinal scale,post-operative clinical recovery (time to return of bowel function, time to first oral intake, time to first ambulation, length of in-hospital stay) at 48 hours after patient has arrived at recovery room Norminal scale,patient satisfaction with pain management at 48 hours after patient has arrived at recovery room ordinal scale | — |
Countries
Thailand
Contacts
Public ContactPornpatra Areeruk
Department of Anesthesiology Faculty of Medicine Ramathibodi Hospital, Mahidol University
Outcome results
None listed