Ultrasound Guided Erector Spinae Plane Block Versus Quadratus Lumborum Block in Laparoscopic Cholecystectomy

Study Overview
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Brief Summary
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The aim of this study is to compare between the efficacy of ultrasound guided erector spinae plane block and ultrasound guided quadratus lumborum block in managing acute postoperative pain in patients undergoing laparoscopic cholecystectomy.

Official Title
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Ultrasound Guided Erector Spinae Plane Block Versus Quadratus Lumborum Block for Postoperative Analgesia in Laparoscopic Cholecystectomy Surgeries: A Randomized Controlled Trial

Conditions
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Laparoscopic Cholecystectomy, Postoperative Analgesia, Erector Spinae Plane Block, Quadratus Lumborum Block

Intervention / Treatment
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* Other: Control group
* Procedure: Erector spinae plane block group
* Procedure: Quadratus lumborum block group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: aged 21-65 years both genders American Society of Anesthesiology (ASA) class I-II Undergoing elective laparoscopic cholecystectomy Exclusion Criteria: Patient refusal. Coagulopathy. History of allergy to local anaesthetic. History of liver or renal pathology affecting drug elimination Mental dysfunction or cognitive disorders. Use of medication such as gabapentin-pregabalin that could affect pain perception. Body Mass Index > 40 kg/m2.

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Control group<br>patients will receive general anesthesia only. | Other: Control group<br>* patients will receive general anesthesia only.<br>* Other names: Group C;|
| Experimental: Erector spinae plane block group<br>patients will receive general anesthesia and bilateral ultrasound guided erector spinae plane block (20ml Bupivacaine 0.25%) | Procedure: Erector spinae plane block group<br>* patients will receive general anesthesia and bilateral ultrasound guided erector spinae plane block (20ml Bupivacaine 0.25%)<br>* Other names: group ESPB;|
| Experimental: Quadratus lumborum block group<br>patients will receive general anesthesia and bilateral ultrasound guided quadratus lumborum block (20 ml Bupivacaine 0.25%) | Procedure: Quadratus lumborum block group<br>* patients will receive general anesthesia and bilateral ultrasound guided quadratus lumborum block (20 ml Bupivacaine 0.25%)<br>* Other names: group QLB;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The degree of postoperative pain in the first 24 hours post-operative | Postoperative pain will be assessed by the numerical rating scale (NRS); 0 no pain while 10 is the maximum pain) after discharge to the ward ,and at 6, 12, 18, 24 hours. | first 24 hours post-operative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to first analgesic requirement | Intravenous morphine 2 mg will be given when the numerical rating scale (NRS) equal or above 4 | first 24 hours post-operative | 
| Total dose of intraoperative consumption of fentanyl | Fentanyl 0.5 μg/kg will be given if there was increase in heart rate or mean arterial blood pressure more than 20% (after exclusion of other causes than pain). | intraoperative | 
| Total dose of rescue analgesia in the first 24hr postoperative | Total morphine consumption 24 hours after surgery will be recorded. Intravenous morphine 2 mg will be given when the numerical rating scale (NRS) equal or above 4 | first 24 hours post-operative |