Clinical trial NCT06721039: Comparison of Ultrasound-Guided Quadratus Lumborum Plane Block Versus Intraperitoneal and Periportal Bupivacaine Infiltration in Postoperative Analgesia After Laparoscopic Cholecystectomy
Official title: Comparison of Ultrasound-Guided Quadratus Lumborum Plane Block Versus Intraperitoneal and Periportal Bupivacaine Infiltration in Postoperative Analgesia After Laparoscopic Cholecystectomy
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Quadratus Lumborum
Laparoscopic Cholecystectomy
Ultrasound Guided
Post Operative Analgesia
Keywords: Quadratus Lumborum Plane Block, Intraperitoneal and Periportal Bupivacaine Infiltration, Post Operative Analgesia, Laparoscopic Cholecystectomy
Lead sponsor: medina medical center
Sponsor class: OTHER
First posted: 2024-12-06
Enrollment: 70
Sex: ALL
Minimum age (years): 21
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The primary outcome: is measured by pain at rest and upon mobilization according to VAS. VAS for pain (ranging from 0 to 10, where 0 no pain and 10 maximum pain) will be evaluated postoperatively and every 2 hours during the first 6 hours and then every 6 hours for 24 hours postoperatively.

Detailed description: Since the concept of day case surgeries is getting more popular, surgeons and anesthesiologists are trying their best to provide adequate post-operative analgesia. The proper management of post-operative pain ensures early ambulation of patients and obviates many post-operative complications.

The most common modality for post-operative pain management has remained the parenteral use of non-steroidal anti-inflammatory drugs (NSAIDs) and opioids.

Intraperitoneal and periportal infiltration with local anesthetic agents has also remained a popular method to take care of immediate postoperative pain. This technique is virtually cost-free, rapid, and hardly requires any special technical experience or equipment for its use. But as there are advances in anesthetic techniques, more and more regional blocks are being tried to take care of post-operative pain. The choice of anaesthetic block technique depends upon the site of surgical incision proposed.

Quadratus lumborum (QL) block is a posterior abdominal wall block which permits the spread of local anesthetic agent behind the quadratus lumborum muscle into a triangular space known as a lumbar interfacial triangle, which lies beside the middle layer of the thoracolumbar fascia.

This interfacial plane is in adjoining proximity with numerous sympathetic fibers and conjoin with the thoracic paravertebral space, thus preceding to a long-standing block with the capability to provide visceral analgesia (Kadam, 2013).

Eligibility criteria: Inclusion Criteria:

* Age 21-60 years of both sexes.
* Elective laparoscopic cholecystectomy under general anesthesia.
* Physical Status: ASA I and II patients after taking written and informed consent.

Exclusion Criteria:

* • Refusal of procedure or participation in the study by patients.

  * Physical status: ASA III or above.
  * Infection at site of injection.
  * Psychiatric illness that leads to inability to cooperate, speak or read.
  * Daily use of opioids.
  * History or evidence of coagulopathy especially if INR\>1.5 and platelet \<100.000
  * Allergies to drugs used (Bupivacaine 0.5%).

Primary outcomes:
measure: pain score postoperative
timeFrame: 24 hours
Secondary outcomes:
Other outcomes:
Locations:
city: New Damietta
country: Egypt
facility: Al-Azhar University Faculty of Medicine
Study officials:
References: