Quadratus lumborum (QL) block can reduce intraoperative opioid consumption, decrease inflammation responses of IL-6, and reduce acute pain intensity in comparison with non-receiving QL block as the control group.
Quadratus lumborum block had been studied as an effective postoperative analgesia in lower abdominal surgery, due to its spread to the thoracic paravertebral space and thoracolumbar fascia nerve. The effect of preincisional ultrasound (US)-guided QL block as "preemptive analgesia" on patient underwent laparoscopic living donor nephrectomy has never been evaluated. As preemptive analgesia, quadratus lumborum block could provide analgesics before and after surgery. Both groups immediately received basic postoperative analgesia regimen paracetamol 1 gr IV 8th hourly.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
DOUBLE
Enrollment
44
Bilateral lateral Quadratus Lumborum block using 20 ml of 0.25% bupivacaine each injection as preemptive analgesia.
Only received fentanyl IV during surgery.
Rumah Sakit Cipto Mangunkusumo
Jakarta Pusat, DKI Jakarta, Indonesia
Intraoperative fentanyl consumption
Intraoperative fentanyl consumption was recorded as total consumption in µg, and calculated into mean consumption per hour in µg.kg-1.h-1, due to the influence of patients body weight and duration of surgery to the given dose of fentanyl boluses.
Time frame: Intraoperative
Changes in Interleukin-6 from baseline
Measurement of plasma Interleukin-6 before the anaesthesia induction as the baseline; 2 hours of surgical stimulation and gas insufflation intraoperatively; and 2 hours after recovery from anaesthesia.
Time frame: 24 hours
Numerical Rating Scale
Pain measurement using Numerical Rating Scale (NRS) at rest and during movement. NRS from 0 =no pain to 10= worst pain at 2 hours and 24 hours after anaesthesia recovery
Time frame: 24 hours
Hemodynamic Profiles: Heart Rate in bpm
The trends of perioperative haemodynamic profiles during and after surgery: heart rate in beat per minute
Time frame: Intraoperative
Hemodynamic Profiles: Systolic, Diastolic, and Mean Arterial Pressure in mmHg
The trends of perioperative haemodynamic profiles during and after surgery : systolic, diastolic and mean arterial pressure in mmHg
Time frame: Intraoperative
Number of participants with additional intravenous tramadol
During observation after surgery, when the NRS began to increase \> 3 at rest the intermittent tramadol 50 mg IV boluses was given 8th hourly. If the NRS still remained \> 3, the intermittent tramadol 50 mg IV boluses were administered more frequently up to 4th hourly.
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Time frame: 24 hours
Number of participants with additional intravenous fentanyl
If the pain relief was still inadequate after increasing tramadol boluses, the extra fentanyl 1 µg.kg\^-1 IV boluses was given at every 15-30th minute until the NRS ≤ 3.
Time frame: 24 hours