Comparison of Postoperative Analgesic Efficacy of the Erector Spina Plane Block and Quadratus Lumborum Block in Open Nephrectomy: a Prospective Randomized Clinical Study

Study Overview
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Brief Summary
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patients who will undergo elective open nephrectomy will be divided into three groups; the control (PCA), the erector spina plane block, and the quadratus lumborum block. After standard anesthesia induction and monitorization then Bispectral index monitoring will be applied to all patients. Anesthesia will be maintained using sevoflurane in a mixture of oxygen and air. Continuous remifentanil infusion will be used for analgesia. Then patient's numeric rating scales and morphine pca consumptions will be recorded for one day.

Detailed Description
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patients who will undergo elective open nephrectomy will be divided into three groups; the control (PCA), the erector spina plane block and the quadratus lumborum block. After standard anesthesia induction and monitorization then Bispectral index monitoring will be applied to all patients. Anesthesia will be maintained using sevoflurane in a mixture of oxygen and air. Continious remifentanil infusion will be used for analgesia. Then patient's numeric rating scales and morphine pca consumptions will be recorded for one day.

Official Title
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Comparison of Erector Spina and Quadratus Lumborum in Open Nephrectomy

Conditions
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Renal Cell Carcinoma

Intervention / Treatment
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* Procedure: preoperative remifentanil consumption
* Procedure: postopeartive controlled anlagesia with morphine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA 1-3 open nephrectomy elective patients BMI<35 Exclusion Criteria: ASA 4-5-6 Laparoscopic nephrectomy infection at the block side coagulation disorder BMI>35

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 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: Diagnostic
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: patient controlled analgesia<br>this group of patients received no block, received only postoperative patient-controlled analgesia with morphine | Procedure: preoperative remifentanil consumption<br>* continuous remifentanil infusion will applied for peroperative analgesia<br>Procedure: postopeartive controlled anlagesia with morphine<br>* postoperative morphine patient controlled analgesia will be applied for postoperative analgesia<br>|
| Active Comparator: erector spina plane block<br>this group of patients received erector spina plane block preoperatively, received only postoperative patient-controlled analgesia with morphine | Procedure: preoperative remifentanil consumption<br>* continuous remifentanil infusion will applied for peroperative analgesia<br>Procedure: postopeartive controlled anlagesia with morphine<br>* postoperative morphine patient controlled analgesia will be applied for postoperative analgesia<br>|
| Active Comparator: quadratus lumborum block<br>this group of patients received erector spina plane block preoperatively, received only postoperative patient-controlled analgesia with morphine | Procedure: preoperative remifentanil consumption<br>* continuous remifentanil infusion will applied for peroperative analgesia<br>Procedure: postopeartive controlled anlagesia with morphine<br>* postoperative morphine patient controlled analgesia will be applied for postoperative analgesia<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postoperative morphine consumption | amount of postoperative morphine use of the patient's | 24 hour postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| peroperative remifentanil consumptions | amount of remifentanil use of the patient's | 4 hour preoperatively | 
| numeric rating scale | numeric rating scores of the patient's postoepartively | 24 hour postoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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erector spina plane block, quadratus lumborum block, patient controlled analgesia, nephrectomy, analgesia