The goal of postoperative pain management is the provision of comfort, early mobilization and improved respiratory function without causing inadequate sedation and respiratory compromise, which can be achieved through using regional anethesia. This study aimed to assess the analgesic effect of adding dexamethasone or magnesium sulphate with bupivacaine in ultrasound-guided QLB to prolong its duration in patients undergoing open abdominal surgeries in the early postoperative period regarding pain relief After approval of the ethical committees in Ain Shams University Hospitals, patients undergoing open abdominal surgeries were included in the study, and were divided into three groups (n=22; each); group M, D and group C. In Group A, patients (n=22) received 20 ml bupivacaine 0.25% plus 5 ml of 10% MgSO. In group B, patients (n=22) received 20 ml bupivacaine 0.25% plus 8 mg dexamethasone (2 ml) plus 3 ml 0.9% NaCl. In group C (control), patients (n=22) received 20 ml bupivacaine plus 5 ml 0.9% NaCl.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
66
Patients received QL block with 20 ml of 0.25% bupivacaine (2, 4)plus 5 ml of 10% MgSO4.
Patients received QL block with 20 ml of 0.25% bupivacaine (2,4)plus 2 ml of 8 mg dexamethasone plus 3 ml of 0.9% NS.
Patients received QL block with 20 ml of 0.25% bupivacaine (2,4)plus 5 ml of 0.9% NS.
Ain-Shams University
Cairo, Egypt
Duration of post-operative analgesia
Time from completion of the block to the first request of rescue analgesia.
Time frame: 24hours
Mean arterial blood pressure
Measured before induction of anesthesia (base line), upon arrival to the PACU, after 30 and 60 min. If hypotension (MBP \< 20% of the base line value) occurred, 3 mg increments of ephedrine repeated every 5 min if required was given. MBP was then recorded at 2, 6, 12 and 24 post-operative hours.
Time frame: 24 hours
Heart rate
Recorded before induction of anesthesia (base line),upon arrival to the PACU, after 30 and 60 min. If bradycardia (HR \<50 bpm) occurred, 0.5 mg atropine was given. HR was then recorded at 2, 6, 12 and 24 post-operative hours.
Time frame: 24 hours
The severity of post-operative pain at rest
By using the Visual Analogue Scale (VAS); from 0= no pain, to 10=worst imaginable pain. Assessed upon arrival to the PACU, after 30 and 60 min. The VAS was then recorded at 2, 4, 6, 8, 12 and 24 post-operative hours.
Time frame: 24 hours
The severity of post-operative pain with movement (bilateral knee flexion)
By using the Visual Analogue Scale (VAS); from 0= no pain, to 10=worst imaginable pain. Assessed at 2, 4, 6, 8, 12 and 24 post-operative hours
Time frame: 24 hours
Number of patients requiring post-operative rescue analgesia
Number of patients requiring pethidine in the 24 hours post-operative period
Time frame: 24 hours
Total dose of pethidine given
The cumulative total pethidine doses given to each patient in the 24 hours post-operative period.
Time frame: 24 hours
Occurrence of nausea and/or vomiting:
Number of patients who develop nausea and/or vomitting
Time frame: 24 hours
Time to first ambulation
The time to the start of movement by each patient in the 24 hours post-operative period
Time frame: 24 hours
The analgesic satisfaction at 24 post-operative hours
Patients were asked to report their satisfaction with the pain management; assessed as, 1 = poor, 2 = fair, 3 = good, and 4 = excellent.
Time frame: 24 hours
Inadvertent femoral nerve block
number of patients who develop lower limb weakness
Time frame: 24 hours
Local Anesthetic Systemic Toxicity (LAST):
As any regional anesthesia technique with local anesthetic is associated with potential systemic absorption of local anesthetics.
Time frame: 24 hours
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