Effect of Quadratus Lumborum Block on Perioperative Analgesia and Inflammatory Responses in Laparoscopic Nephrectomy

University of Indonesia (UI)

Status: Completed

Conditions: Postoperative Pain

Treatments: Drug: Non-QL block; Drug: Bilateral QL block

Study type: Interventional

Funder types: Other

Identifiers

NCT03879980

IndonesiaUAnes031

Details and patient eligibility

About

Quadratus lumborum (QL) block can reduce intraoperative opioid consumption, decrease inflammation responses of IL-6, and reduce acute pain intensity in comparison with non-receiving QL block as the control group.

Full description

Quadratus lumborum block had been studied as an effective postoperative analgesia in lower abdominal surgery, due to its spread to the thoracic paravertebral space and thoracolumbar fascia nerve. The effect of preincisional ultrasound (US)-guided QL block as "preemptive analgesia" on patient underwent laparoscopic living donor nephrectomy has never been evaluated. As preemptive analgesia, quadratus lumborum block could provide analgesics before and after surgery. Both groups immediately received basic postoperative analgesia regimen paracetamol 1 gr IV 8th hourly.

Enrollment: 44 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• BMI < 30 kg/m2
• ASA 1 or 2

Exclusion criteria

• refused to participate
• chronic use of analgesics or anti-inflammatory drugs
• allergy to local anaesthetic
• duration of surgery <4 or > 6 hours
• duration of anaesthesia <5 or > 7 hours
• neuropathy

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

44 participants in 2 patient groups, including a placebo group

Non-QL block

Placebo Comparator group

Description:

The control (non-QL block) group only received fentanyl IV during surgery.

Treatment:

Drug: Non-QL block

Bilateral QL block

Experimental group

Description:

The patients were in the semi-lateral supine position to show up the side to be blocked. Using USG and 1-6 MHz convex transducer placed in the transverse plane above the iliac crest at the level of the umbilicus. A Stimuplex® 20G 100-mm needle was advanced in anteroposterior direction toward the junction of tapered abdominal muscle layer and QL muscle, and 20 ml of 0.25% bupivacaine was deposited in the anterolateral border of QL muscle at the junction with the transversalis fascia reach outside the anterior layer of transversalis fascia. The lateral approach QL (type I) blocks were performed at both sides of patients. The total amount of bupivacaine was 100 mg for each patient

Treatment:

Drug: Bilateral QL block