QLB After Nephrectomy

Study Overview
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Brief Summary
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Oxycodone consumption and postoperative pain intensity in patients undergoing nephrectomy procedures. Of all study participants, 50% will obtain quadratus lumborum block (QLB).

Detailed Description
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Patients undergoing nephrectomy procedures will be allocated to one of the study arms. At the end of an operation, still under general anesthesia, 50% patients will obtain QLB with ropivacaine. Ultrasound-guided QLB will be performed on the side of surgery with 0.375% ropivacaine solution (0.2 mL per kg). Every patient will get patient-controlled analgesia pump with oxycodone in the postoperative period. Postoperative pain will be measured with VAS (visual-analogue scale) 2, 4, 8, 12 and 24 hours after the end of the operation. 24 -hours period. At the 1, 3, 6 months patients will be interviewed by phone to assess neuropathic pain. Neuropathic Pain Symptom Inventory (NPSI) will be used.

Official Title
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Effectiveness of Quadratus Lumborum Block After Nephrectomy

Conditions
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Pain, Postoperative, Chronic Postoperative Pain

Intervention / Treatment
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* Procedure: QLB
* Device: PCA
* Procedure: GA
* Drug: Oxycodone
* Drug: Sevoflurane
* Drug: Fentanyl
* Drug: Rocuronium


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: obtained consent nephrectomy procedure Exclusion Criteria: coagulopathy allergy to local anesthetics depression, antidepressant drugs treatment epilepsy usage of painkiller before surgery addiction to alcohol or recreational drugs

Ages Eligible for Study
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Minimum Age: 18 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Patients will be randomly allocated to one of the study arms: QLB or control group.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: QLB<br>At the end of surgery, QLB with ropivacaine will be done on the side of the operation. | Procedure: QLB<br>* On the side of the surgery, QLB with 0.375% ropivacaine (0.2 mL/kg)<br>Device: PCA<br>* Patient-controlled analgesia<br>Procedure: GA<br>* General anesthesia<br>Drug: Oxycodone<br>* administered by PCA<br>Drug: Sevoflurane<br>* Inhalational anesthetic during GA<br>Drug: Fentanyl<br>* painkiller during GA<br>Drug: Rocuronium<br>* muscle relaxant during GA<br>|
| Experimental: Control<br>Standard care. No regional blocks. | Device: PCA<br>* Patient-controlled analgesia<br>Procedure: GA<br>* General anesthesia<br>Drug: Oxycodone<br>* administered by PCA<br>Drug: Sevoflurane<br>* Inhalational anesthetic during GA<br>Drug: Fentanyl<br>* painkiller during GA<br>Drug: Rocuronium<br>* muscle relaxant during GA<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total consumption of oxycodone | Overall use of oxycodone administered by PCA pump will be assessed. | 24 hours after the end of surgery. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain intensity | Pain intensity measured on VAS scale at the 2, 4, 8, 12, 24 hours. VAS in milimmeters. Minimum value 0, maximum 100. Less better - less severe pain. 0 no pain at all. | 24 hours after the end of surgery | 
| Chronic pain | Chronic pain occurrence assessed with Neuropathic Pain Symptom Inventory (NPSI) 10 descriptive variables, each one from 0 to 10. 0 means no pain. 10 very high chance of occurrence of neuropathic pain. | 6 months after the surgery |