Quadratus Luborum Block Using Bupivacaine Versus Bupivacaine-Dexamethasone in Laparoscopic Cholecystectomy

Minia University

Status: Completed

Conditions: Post Operative Pain

Treatments: Drug: TQL block with saline; Drug: TQL block with Bupivacaine; Drug: TQL block with Bupivacaine and dexamethasone

Study type: Interventional

Funder types: Other

Identifiers

NCT03956966

88-11/2018

Details and patient eligibility

About

The aim of the present study was to compare the effectiveness of transmuscular Quadratus Lumborum block using Bupivacaine versus Bupivacaine- Dexamethasone in providing analgesia in patients undergoing laparoscopic cholecystectomy.

Because postoperative pain after laparoscopic surgery is complex, specialists suggest that effective analgesic treatment should be a multimodal support. Quadratus lumborum block (QLB) is a new abdominal truncal block for controlling somatic pain in both the upper and lower abdomen. Dexamethasone, through its anti-inflammatory and blocking effects on neural discharge, and nociceptor C fibers transmission could be used as a local anesthetic adjuvant.

Full description

The patients were randomly allocated into three groups each contains (30) patient. Control group (C) received bilateral ultrasound guided quadratus lumborum block using (20 ml 0.9% normal saline + 1mL 0.9% normal saline) in each side ,Bupivacaine group (B) received bilateral quadratus lumborum block using (20 ml Bupivacaine hydrochloride 0.25% + 1mL 0.9% normal saline) in each side and Dexamethasone-Bupivacaine group (D) received bilateral quadratus lumborum block using (20 ml Bupivacaine hydrochloride 0.25% + 1 mL dexamethasone "4mg") in each side.

The following variables: heart Rate, mean arterial Blood Pressure, peripheral oxygen saturation, visual analogue pain scale , time to first analgesic request, total Analgesic requirement in the first 24 hours, patient satisfaction and complications were Recorded and compared between groups.

Enrollment: 90 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Physical Status I or II
• Elective laparoscopic Cholecystectomy

Exclusion criteria

• Patient refusal.
• Hematological diseases
• Bleeding disorders.
• Coagulation abnormality.
• Psychiatric diseases.
• Local skin infection
• Sepsis at site of the block.
• Known intolerance to the study drugs.
• Body Mass Index > 40 Kg/m2.
• Emergency laparoscopic cholecystectomy
• If laparoscopic procedure converted to open.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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90 participants in 3 patient groups, including a placebo group

saline

Placebo Comparator group

Description:

bilateral quadratus lumborum block using 0.9% normal saline

Treatment:

Drug: TQL block with saline

Bupivacaine

Active Comparator group

Description:

bilateral quadratus lumborum block using Bupivacaine hydrochloride 0.25%

Treatment:

Drug: TQL block with Bupivacaine

Bupivacaine and dexamethasone

Active Comparator group

Description:

bilateral quadratus lumborum block using Bupivacaine hydrochloride 0.25% and dexamethasone

Treatment:

Drug: TQL block with Bupivacaine and dexamethasone