Preoperative Versus Postoperative Quadratous Lunborum Block in Nephrectomy

Ain Shams University

Status: Not yet enrolling

Conditions: Renal Surgery; Regional Blocks

Treatments: Other: quadratous lumborum block

Study type: Interventional

Funder types: Other

Identifiers

NCT05860309

MS 183/2023

Details and patient eligibility

About

A multimodal analgesia regimen is suggested after nephrectomy, although some patients still report agonising pain. Regional anesthesia approaches may improve postoperative pain management and reduce the requirement for opioids after renal surgery.QLB provides early and rapid pain relief

Full description

In the immediate postoperative period, nerve blocks are considered a type of multimodal analgesia and have recently been proposed as analgesic options for patients undergoing open nephrectomy .

Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. The main barrier to early postoperative ambulation is postoperative pain, which also lengthens hospital stays and raises the risk of respiratory problems and venous thromboembolism. Therefore, strict perioperative pain management can have both immediate and long-term advantages .

QLB provides early and rapid pain relief and allows early ambulation in certain patient populations. Multiple case studies also confirmed the QLB to be a rescue block after different surgical procedures. Complications associated with the performance of abdominal wall blocks are fortunately very rare. However, studies on the effect of anterior QLB on postoperative opioid consumption are scarce .

Regional anesthesia is quickly moving toward using ultrasound guidance as the gold standard. The use of ultrasound has significant advantages over traditional treatments such as nerve stimulation and loss of resistance. The improved safety and efficacy that ultrasound brings to regional anaesthesia will help promote its use and realise the benefits that regional anaesthesia has over general anaesthesia, such as decreased morbidity and mortality, superior postoperative analgesia, cost-effectiveness, decreased postoperative complications and an improved postoperative course .

The aim of the present study is to compare the effectiveness of ultrasound-guided preoperative to postoperative QLB on the postoperative pain scores after Radical nephrectomy.

Enrollment: 100 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• o Patients aged between 18 - 60 years old.

  • Both sexes.
  • Physical Status: ASA I and II.

Exclusion criteria

• o Refusal of procedure or participation in the study .

  • Physical status: ASA III or above .
  • Infection at site of injection.
  • Psychiatric illness .
  • CNS Diseases like epilepsy, stroke ...etc.
  • History or evidence of coagulopathy .
  • Allergies to drug used (Bupivacaine 0.5%).
  • Patients who suffered from allergy to local anesthetics .
  • Difficult visualization of the anatomy.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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100 participants in 2 patient groups

preoperative quadratous lumborum block

Active Comparator group

Description:

patients weill recieve preoperative ultrasound guided quadratous lumborum block at lateral position before start of surgery after induction of general anesthesia

Treatment:

Other: quadratous lumborum block

postoperative quadratous lumborum block

Active Comparator group

Description:

patients weill recieve postoperative ultrasound guided quadratous lumborum block at lateral position at the end of surgery before recovery from general anesthesua

Treatment:

Other: quadratous lumborum block