Continous Quadratus Lumborum Block for Hepatic Surgery With Right Subcostal Incision

Study Overview
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Brief Summary
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This prospective, randomized study, control study aims to compare the analgesic effect, opioids consumption, quality of recovery, length of hospital stay and et al. between unilateral continuous quadratus lumborum block (QLB) and intravenous patient-controlled analgesia (IPCA) alone in patients undergoing hepatectomy with right J-shape subcostal incision.

Official Title
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Ultrasound-guided Continous Quadratus Lumborum Block: Effect on Acute Pain and Quality of Recovery After Hepatic Surgery With Right Subcostal Incision

Conditions
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Hepatectomy, Analgesia, Nerve Block

Intervention / Treatment
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* Procedure: Continous QLB (quadratus lumborum block)
* Device: Philip CX50 Ultrasound Scanner
* Drug: Ropivacaine
* Drug: Morphine given as IPCA


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18-70 yrs American Society of Anesthesiologists physical statusⅠ-Ⅲ Undergo hepatectomy with right J-shape subcostal incision Informed consent Exclusion Criteria: A known allergy to the drugs being used Coagulopathy, on anticoagulants Analgesics intake, history of substance abuse Participating in the investigation of another experimental agent Inability to properly describe postoperative pain to investigators (eg, language barrier, neuropsychiatric disorder)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 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: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Continuous QLB+postoperative IPCA<br>Single-injection of QLB (quadratus lumborum block) is given preoperatively followed with continuous infusion+ postoperative IPCA (intravenous patient control analgesia) | Procedure: Continous QLB (quadratus lumborum block)<br>* Inject local anesthetics in between quadratus lumborum and psoas major muscle with catheter insertion and continuous local infusion<br>* Other names: Inject local anesthetics in between quadratus lumborum and psoas major muscle with catheter insertion and continuous local infusion;Device: Philip CX50 Ultrasound Scanner<br>* The curved (C1-5) probe of Philip CX 50 Ultrasound Scanner is used for scan<br>Drug: Ropivacaine<br>* 0.6ml/kg 0.5% ropivacaine with 1:200,000 adrenaline given immediately after the correct position of the tip of the needle has been verified. followed with 0.2% ropivacaine infusion at a rate of 0.125ml/kg/h given through the catheter inserted in between the quadratus lumborum muscle and psoas major muscle.<br>Drug: Morphine given as IPCA<br>* Bolus: 1-2mg, lock time: 10min, 1h limitation: 5-10mg. without background infusion.<br>|
| Active Comparator: IPCA<br>Postoperative IPCA (intravenous patient control analgesia) is given alone | Drug: Morphine given as IPCA<br>* Bolus: 1-2mg, lock time: 10min, 1h limitation: 5-10mg. without background infusion.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cumulative morphine consumption |  | at 24 postoperative hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The pain scores determined by the numeric rating scale (NRS, 0-10) |  | At 0, 2,4, 8, 12, 24 ,48,72 hours and 7 day after the surgery | 
| Nausea and Vomiting score |  | At 0, 2,4, 8, 12, 24 and 48 hours after the surgery | 
| Pruritus score |  | At 0, 2,4, 8, 12, 24 and 48 hours after the surgery | 
| Ambulation time |  | within the 7 days after surgery | 
| Time of recovery of bowl movement |  | within the 7 days after surgery | 
| Quality of recovery | use the self-assessment 11 item QoR scale to assess the patient's recovery quality | 3 days and 7 days after surgery | 
| Patient satisfaction with anesthesia | use the Chinese version Bauer questionnaire to assess the patient satisfaction with anesthesia | 48 hours after surgery | 
| Postoperative hospital length of stay |  | Up to 6 weeks |