Postoperative Pain Clinical Trial
Official title:
Comparison of Quadratus Lumborum Block and Transversus Abdominis Plane Block for Postoperative Pain Control After Laparoscopic Cholecystectomy
In this study, investigators aimed to compare the Quadratus Lumborum Block and the Transversus Abdominis Plan Block for postoperative pain control after laparoscopic cholecystectomy
After ethical committee approval, informed written consent will be obtained from all
patients.
A Sample size of 60 patients (30 per group) was calculated based on 15% reduction in morphine
consumption with 0.05% significance and a power of 0.8.
Consenting patients scheduled to have elective laparoscopic cholecystectomy under general
anesthesia will be randomized to receive bilateral QLB or TAP before the surgery. The dose of
local anesthetic in both groups will be 20 ml 0.25% Bupivacaine. Allocation to either group
will be done using permuted block randomization method.
Patients will be taken to the block room 1 hour before surgery. ECG, NIBP and SpO2 monitor
will be done. The IV access route will be provided. The patient will be given 0.03 mg / kg IV
midazolam for routine premedication. Block will be applied by a blind anesthetist to the
other data of the study. Under ultrasound guidance a 22 Gauge Sonoplex needle will be used
for both techniques. The calculated dose of local anesthetic will be injected bilaterally
with intermittent aspiration. The spread of injectate will be seed on ultrasound.
The procedure time for both blocks will be recorded and 30 minutes after the procedure is
completed, and the patient will be taken to the operation room. General anesthesia will be
applied to the patient in the operation procedure in the standard procedure. Intraoperative
heart rate and / or mean arterial pressure is increased to 20% of the basal value and 0.5 mcg
/ kg IV fentanyl will be added. 30 minutes before the end of operation, 1 mg IV paracetamol
and NSAID (dexketoprofen) 50 mg IV will be administered to the patient before extubation. The
patient will be infected with IV PCA in the morphine. PC 1 mg IV bolus dose will be adjusted
to 10 minutes of locked-out period. In the postoperative period, 4 * 1 gr / 24 h IV
paracetamol will be given to each patient.
All patients will be assessed postoperatively by a blinded investigator: in the
post-anesthesia care unit and at 0, 2, 4, 6, 12 and 24 h postoperatively.
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