Postoperative Pain Clinical Trial
Official title:
Extrafascial Injection Versus Subfascial Injection of Quadratus Lumborum Block for Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy
Quadratus lumborum block can be used for the hip surgery and abdominal surgery postoperative analgesia. But the lower thoracic to the hip dermatome can't be blocked at the same time. The anesthetists used the same method, but had produced the different dermatome were blocked. The investigators hypothesized that this was due to local anesthetics was injected to different locations of the anterior thoracolumbar fascia. If the investigators inject local anesthetics to the anterior layer of thoracolumbar extrafascial, this produced the dermatomal coverage from lower abdominal to hip. A different situation was when the investigators injected local anesthetics to anterior thoracolumbar subfascia, the lower thoracic dermatome were blocked.
Quadratus lumborum block can be used for the hip surgery and abdominal surgery postoperative
analgesia. But the lower thoracic to the hip dermatomes can't be blocked at the same time.
The anesthetists used the same method, but had produced the different dermatomes were
blocked. The investigators hypothesized that this was due to local anesthetics was injected
to different locations of the anterior thoracolumbar fascia. If the investigators inject
local anesthetics to the anterior thoracolumbar extrafascial (between the anterior layer of
thoracolumbar fascia and psoas major muscle), this produced the dermatomal coverage from
lower abdominal to hip. In this case, the investigators speculated the local anesthetic
spread to the lumbar paravertebral space via the fascia and the fascicle of psoas major. A
different situation was when the investigators injected local anesthetics to anterior
thoracolumbar subfascial (between the anterior layer of thoracolumbar fascia and quadratus
lumborum), the lower thoracic dermatomes were blocked. The investigators speculate that the
local anesthetic injected subfascial could spread cephalad to lower thoracic paravertebral
space posterior to the endothoracic fascia via lateral arcuate ligament.
The investigators confirm the hypothesis in the pilot trial. therefore, the investigators
need to trial with large sample. The investigators plan to improve the clinical guidance of
quadratus lumborum block technology, so that more patients benefit.
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