Transversus Abdominis Plane Block Versus Quadratus Lumborum Block for Pain Management in Laparoscopic Appendectomy

Study Overview
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Brief Summary
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Laparoscopic appendectomy causes postoperative pain. The primary objective of this prospective randomized controlled study is to compare the effect of ultrasound (US)-guided quadratus lumborum block (QLB) on 24-hour cumulative opioid requirements with transversus abdominis plane (TAP) block.

Detailed Description
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168 patients (ASA I-II-III) between 18 and 65 years of age, who were to undergo laparoscopic appendectomy, were randomized and divided into two groups. 32 patients were dropout for different reasons.(68 patients in each of the TAP block and QLB block groups). TAP block was performed for TAP group and QLB block was performed for QLB group. Postoperative analgesia was provided by intravenous tramadol hydrochloride using a patient-controlled analgesia device. 24-hour total tramadol hydrochloride consumption was primary outcome measure.Postoperative numeric rating scale values were the secondary outcome measure.

Official Title
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Ultrasound-guided Transversus Abdominis Plane Block Versus Quadratus Lumborum Block for Postoperative Analgesia in Laparoscopic Appendectomy: A Prospective, Randomized, Controlled Clinical Study

Conditions
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Post Operative Pain, Appendicitis Acute, Surgery

Intervention / Treatment
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* Procedure: Transversus abdominis plane block
* Procedure: Quadratus Lumborum Block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Ages of 18-65 Patients who will undergo laparoscopic appendectomy ASA I-II-III patients Exclusion Criteria: Clinically known local anesthetic allergy Morbid obesity (body mass index>40 kg m2) Clinically diagnosis of opioid, alcohol and substance dependence Clinically diagnosis of psychiatric disease Coagulopathy Patients with ASA IV-V

Ages Eligible for Study
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Minimum Age: 18 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: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group TAP<br>The investigators performed transversus abdominis plane block to that patient group for postoperative analgesia | Procedure: Transversus abdominis plane block<br>* The investigators performed transversus abdominis plane block to that patient group for postoperative analgesia<br>|
| Active Comparator: Group QLB<br>The investigators performed quadratus lumborum block to that patient group for postoperative analgesia | Procedure: Quadratus Lumborum Block<br>* The investigators performed quadratus lumborum block to that patient group for postoperative analgesia<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative 24-hours total tramadol hydrochloride consumption | This will be measured by pca device in the 24 hour after | 24 hours postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numerical rating scale (NRS) scores of patients | Numerical rating scale (NRS) at 1, 6, 12, 18, 24th hours. A numerical rating scale (NRS) requires the patient to rate their pain on a defined scale. For example, 0-10 where 0 is no pain and 10 is the worst pain imaginable. | 24 hours postoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Postoperative pain, Laparoscopic appendectomy, Transversus abdominis plane block, Quadratus Lumborum Block, Local anesthetic