Quadratus Lumborum Block : Effect on Acute Pain and Quality of Recovery After Laparoscopic Renal Surgery

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 incidence of chronic pain,et al. between single-injection QLB(quadratus lumborum block)+ intravenous patient-controlled analgesia (IPCA) and intravenous patient-controlled analgesia (IPCA) alone in patients undergoing laparoscopic renal surgeries.

Conditions
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Laparoscopic Renal Surgery, Pain Management, Nerve Block

Intervention / Treatment
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* Procedure: single-injection QLB(quadratus lumborum block)
* Device: Philip CX50 Ultrasound Scanner
* Device: PAJUNK StimuLong
* Drug: single dose ropivacaine
* Drug: Morphine given as IPCA(intravenous patient controlled analgesia)


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 laparoscopic nephrectomy 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: 17 Years
Maximum Age: 80 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: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: single-injection QLB(quadratus lumborum block)<br>Single-injection of QLB is given preoperatively + postoperative IPCA(intravenous patient controlled analgesia) | Procedure: single-injection QLB(quadratus lumborum block)<br>* Inject local anesthetics in between quadratus lumborum and psoas major without continuous local infusion<br>Device: Philip CX50 Ultrasound Scanner<br>* The curved (C1-5) probe of Philip CX 50 Ultrasound Scanner is used for scan<br>Device: PAJUNK StimuLong<br> <br> Drug: single dose 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.<br>Drug: Morphine given as IPCA(intravenous patient controlled analgesia)<br>* bolus: 1.5 2mg, lock time: 10min, 1h limitation: 6 8mg<br>|
| Active Comparator: IPCA<br>postoperative IPCA is given alone | Drug: Morphine given as IPCA(intravenous patient controlled analgesia)<br>* bolus: 1.5 2mg, lock time: 10min, 1h limitation: 6 8mg<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cumulative morphine consumption |  | within 48 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 ,48,72hours after the surgery | 
| nausea and vomiting score |  | within 24 hours after the surgery | 
| pruritus score |  | within 24hour after the surgery | 
| ambulation time |  | within the 7 days after surgery | 
| time of recovery of bowl movement |  | within the 5 days after surgery | 
| quality of recovery | use the self-assessment 15 item QoR scale to assess the patient's recovery | 3days and 5days after surgery | 
| Postoperative hospital length of stay |  | Up to 6 weeks | 
| patient satisfaction with anesthesia | use the Chinese version Bauer questionnaire to assess the patient satisfaction with anesthesia | 48 hours after surgery |