Analgesic Effect of Quadratus Lumborum Block in Laparoscopic Hemicolectomy

Study Overview
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Brief Summary
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Comparison of the effectiveness: Quadratus lumborum (QL) block by levobupivacaine with placebo.

Detailed Description
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All patients will receive standard anaesthesia using fentanyl, protocol, cisatracurium and sevoflurane. Prevention of nausea and vomiting is performing using Apfel score. All patients will receive post operative multimodal analgesia using paracetamol, ketoprofen, tramadol, and trimeperidine if numerical rating scale > 3 The study assumes use of QL block by levobupivacaine.in comparison with placebo in order to demonstrate the effectiveness of QL block during the operation.

Official Title
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Analgesic Effect of Quadratus Lumborum Block in Laparoscopic Hemicolectomy

Conditions
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Post Operative Pain

Intervention / Treatment
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* Procedure: Quadratus lumborum block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who have undergone left-sided or right-sided laparoscopic hemicolectomy. Patient's willingness and ability to sign an informed consent document Exclusion Criteria: Allergy to local anesthetics Chronic pain syndrome and associated opioid use. Coagulopathy Uncontrolled diabetes mellitus Physical Status Classification System scale above 3 Diseases associated with the pathology of the hypothalamus Diseases associated with the pathology of the pituitary gland Diseases associated with the pathology of the adrenal glands

Ages Eligible for Study
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Minimum Age: 18 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
Interventional Model Description: Distribution: randomized Intervention model: parallel distribution 2 groups Control group: patients receiving general anesthesia with propofol, fentanyl and cisatracurium for induction and sevoflurane, fentanyl and cisatracurium for maintaining anesthesia. Patients receiving postoperative multimodal intravenous analgesia with paracetamol, ketoprofen, tramadol, and trimeperidine. Before surgery will be performde bilateral blockade of the QL muscle with normal saline. Study group: patients receiving general anesthesia with propofol, fentanyl and cisatracurium for induction and sevoflurane, fentanyl and cisatracurium for maintaining anesthesia. Patients receiving postoperative multimodal intravenous analgesia with paracetamol, ketoprofen, tramadol, and trimeperidine. The QL blockade will be performed under ultrasound guidance using 20 ml of a solution of levobupivacaine 2.5 mg / ml.
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Study group<br>patients receiving general anesthesia with propofol, fentanyl and cisatracurium for induction and sevoflurane, fentanyl and cisatracurium for maintaining anesthesia. Patients receiving postoperative multimodal intravenous analgesia with paracetamol, ketoprofen, tramadol, and trimeperidine. In this group, after induction of anesthesia before the operation, bilateral blockade of the square dorsi muscle is performed under ultrasound guidance using 20 ml of a solution of levobupivacaine 2.5 mg / ml. | Procedure: Quadratus lumborum block<br>* QL block will be used for perioperative anesthesia. The blockade will be performed bilaterally by levobupivacaine (20ml) at concentration 0.25%.<br>|
| Placebo Comparator: Control group<br>patients receiving general anesthesia with propofol, fentanyl and cisatracurium for induction and sevoflurane, fentanyl and cisatracurium for maintaining anesthesia. Patients receiving postoperative multimodal intravenous analgesia with paracetamol, ketoprofen, tramadol, and trimeperidine. In this group, after induction of anesthesia before surgery, bilateral blockade of the square dorsi muscle is performed under ultrasound guidance using 20 ml of saline. | Procedure: Quadratus lumborum block<br>* QL block will be used for perioperative anesthesia. The blockade will be performed bilaterally by levobupivacaine (20ml) at concentration 0.25%.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| NRS (Numeric rating scale) | NRS scale 0-10, no pain; 10, worst pain imaginable | two hours after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The need for opioid analgesics during surgery |  | on operations | 
| The need for opioid analgesics for postoperative pain relief |  | 72 hours after surgery | 
| The need for antiemetic drugs to relieve postoperative nausea and vomiting |  | 12 hours after the surgery | 
| Occurrence of prolonged post-operative ileus |  | first two weeks after surgery | 
| Blood glucose level |  | after induction into anesthesia, immediately after the end of the surgery, 12 hours after the surgery | 
| The level of blood lactate |  | after induction into anesthesia, immediately after the end of the surgery, 12 hours after the surgery | 
| The level of cortisol in the blood |  | after induction into anesthesia and immediately after the end of the surgery | 
| The level of prolactin in the blood |  | after induction into anesthesia and immediately after the end of the surgery. |