Pre-emptive Quadratus Lumborum Block for Laparoscopic Bariatric Surgery

Study Overview
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Brief Summary
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The purpose of this study was to determine the effectiveness of pre-emptive Quadratus lumborum block on intra, postoperative pain assessment and opioid requirements in laparoscopic bariatric procedures.

Official Title
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Pre-emptive Quadratus Lumborum Block for Laparoscopic Bariatric Surgery.A Prospective Randomizes Controlled Study.

Conditions
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Pain, Postoperative

Intervention / Treatment
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* Procedure: US-guided Quadratus lumborum block.
* Drug: Bupivacaine
* Drug: Saline


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients included in this study are Both genders Age between 18-50 years Those undergoing laparoscopic bariatric surgery (as laparoscopic sleeve gastrectomy or gastric bypass). BMI ≥ 35 Kg/m2 with comorbidity or ≥ 40 Kg/m2 without comorbidity. Exclusion Criteria: Patients excluded from this study were those with obstructive sleep apnoea and/or Pickwickian syndrome. if the laparoscopy procedure was converted to laparotomy. patients suffering from known coagulation defects. known hypersensitivity to bupivacaine, or those with contraindication to the use of NSAIDS. Presence of sepsis at the site of injection.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group Quadratus lumborum block with bupivacaine<br>After induction of anesthesia a QLB (quadratus lumborum block) will be performed by using ultrasound machine where a solution of 0.25% bupivacaine 0.2 ml /kg (lean body weight) is used on each side with care not to exceed the toxic dose. | Procedure: US-guided Quadratus lumborum block.<br>* Performance of quadratus lumborum block using ultrasound machine to relieve pain after bariatric surgery<br>Drug: Bupivacaine<br>* Bupivacaine<br>|
| Placebo Comparator: Group Quadratus lumborum block with saline<br>After induction of anesthesia a QLB (quadratus lumborum block) will be performed by using ultrasound machine.A volume of 0.2ml/kg normal saline will given for each side. | Procedure: US-guided Quadratus lumborum block.<br>* Performance of quadratus lumborum block using ultrasound machine to relieve pain after bariatric surgery<br>Drug: Saline<br>* normal saline<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative pain severity | Assessment of analgesia intraoperatively and for the first 24 hours postoperatively using the numerical ratingscale (NRS)score .The scale ranges from 0 to 10 where 0 indicates no pain and 10 indicates the worst pain imaginable. | 24 hours postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intraoperative hemodynamics | Mean arterial pressure (MAP) in mmHg. | 24 hours postoperatively | 
| Postoperative analgesic needs | Time to first analgesic requirement in hours | 24 hours postoperatively. | 
| Total dose of opioids | Total dose of opioids received in mg | 24 hours postoperatively. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Quadratus lumborum block, laparoscopic bariatric surgery