Quadratus Lumborum Block Clinical Trial
Official title:
1.1 English Title of Research Project: Comparing the Efficacy of Ultrasound Guided Quadratus Lumborum Block Anterior Subcostal Versus Posterior Approach in Managing Postoperative Pain in Patients Undergoing Nephrectomy Surger: A Prospective Randomized Controlled Double Blinded Study
- Primary outcome: to compare the efficacy of Anterior subcostal versus Posterior approach
in ultrasound guided Quadratus Lumborum Block.
- Secondary outcome: to evaluate the efficacy of Quadratus Lumborum Block in the control
of postoperative pain in patients undergoing Nephrectomy surgery, hemodynamics, any
complications and patients' satisfaction..
A variant of the ultrasound-guided transversus abdominis plane (TAP) block was first
described in an abstract, in which local anesthetic injection occurs at the point where the
internal oblique and transversus abdominis muscles taper off and adjoin the lateral border of
quadratus lumborum (QL) muscle.
Currently, the QL block is performed as one of the perioperative pain management procedures
for all generations (pediatrics, pregnant, and adult) undergoing abdominal surgery.
However, there is large disagreement regarding the best approach for administering the block
because of unclear mechanisms responsible for the effects and complicated nomenclature
system. Nephrectomy for patients with renal cell carcinoma (RCC) was first described in 1969.
Surgical treatment varies with the pathology. Simple nephrectomy is the preferred option for
those with non-neoplastic disease (e.g. trauma, non-functioning kidney with chronic
infection) with radical nephrectomy being preferred in those with neoplastic disease. Radical
nephrectomy implies resection of the whole of Gerota's fascia, including the perinephric fat,
lymphatics, and the ipsilateral adrenal gland. Here the investigators are going to compare
the Anterior (subcostal) approach to the Posterior approach to determine their level of
spread and their value in controlling postoperative pain in patients scheduled for
Nephrectomy surgery.
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