Dexmedetomidine as an Adjuvant to Bupivacaine in Ultrasound-Guided Quadratus Lumborum Block for Postoperative Analgesia in Laparoscopic Cholecystectomy

Tanta University

Status: Completed

Conditions: Postoperative Analgesia; Quadratus Lumborum Block; Laparoscopic Cholecystectomy; Bupivacaine; Dexmedetomidine; Ultrasound-Guided

Treatments: Drug: Bupivacaine; Drug: Bupivacaine and Dexmedetomidinc) group

Study type: Interventional

Funder types: Other

Identifiers

NCT06825286

36264MS296/8/23

Details and patient eligibility

About

The aim of this study is to evaluate the effect of adding Dexmedctomidinc as adjuvant to Bubivacaine in Ultrasound-Guided Quadratus Lumborum Block for Postoperative Analgesia in Laparoscopic Cholecystectomy.

Full description

When compared to conventional surgery, laparoscopic cholecystectomy is less invasive and leads to less postoperative pain. However, the postoperative pain following laparoscopic cholecystectomy consists of both somatic and visceral components with pain originating from port entry' wounds, gallbladder resection and abdominal insufflation that leads to peritoneal distention and peritoneal damage.

Quadratus lamborum block (QLB) is abdominal truncal block that provides both somatic and visceral analgesia for both upper and lower abdominal surgical procedures, It was first introduced by Blanco.Currently There are 4 approaches described for QLB: lateral, posterior, anterior and intramuscular. Transmuscular (anterior) QLB Type 3 block involves injection in the plane between the psoas major (PM) and the QL muscles studies have reported spread of the injectate to the thoracic paravertebral space, as well as the spinal nerve which runs anterior to the QL muscle

Enrollment: 90 patients

Sex: All

Ages: 21 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged 21-65 years.
• Both genders.
• American society of Anesthesiology (ASA) class l, II undergoing elective laparoscopic cholecystectomy

Exclusion criteria

• Patient refusal
• History of allergy to local anesthetic.
• Liver or renal pathology affecting drug elimination
• Menta!dysfunction or cognitive disorders.
• Patients on chronic pain medications.
• Body Mass Index > 40 kg/m2.
• Coagulopathy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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90 participants in 2 patient groups

Bupivacaine group

Active Comparator group

Description:

Patients received general anesthesia and bilateral ultrasound guided transmuscular quadratus lumborum block with (20 ml bupivacaine 0.25%)

Treatment:

Drug: Bupivacaine

Bupivacaine and Dexmedetomidinc group

Experimental group

Description:

Patients received general anesthesia and bilateral ultrasound guided transmuscular quadratus lumborum block with (20ml Bupivacaine 0.25%) + (Dexmedetomidine I mic/kg)

Treatment:

Drug: Bupivacaine and Dexmedetomidinc) group