The objective of this study is to assess the analgesic sparing effect of adding Dexamethasone to Bupivacaine in Quadratus lumborum block in patients undergoing Laparoscopic cholecystectomy under general anesthesia.
Background: The QLB is an effective analgesic technique for various abdominal wall incisions. The QLB covers T7 to L2 dermatomes by the spread of LA drugs either into the paravertebral space or in the thoracolumbar plane, through iliohypogastric and ilioinguinal nerves, A and C fiber nociceptors, mechanoreceptors and high-density network of lumbar sympathetic fibers. Objective: To assess the analgesic sparing effect of adding Dexamethasone to Bupivacaine in Quadratus lumborum block in patients undergoing Laparoscopic cholecystectomy under general anesthesia. Patients and Methods: Sixty patients scheduled for elective Laparoscopic cholecystectomy surgeries under general anesthesia were included in this study, they were divided into two groups. Group A (perineural dexamethasone and bupivacaine group) \[n=30\] Those cases will receive 2ml volume of dexamethasone (8mg) combined with 18 ml of bupivacaine of 0.25% concentration. Group B (perineural bupivacaine group) \[n=30\] Those cases will receive perineural 18 ml bupivacaine (0.25%) combined with 2 ml normal saline.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
60
18 ml of bupivacaine of 0.25% injected bilaterally in quadratus lumborum block
dexamethasone
Ain Shams University Hospital
Cairo, EL Abassia, Egypt
measuring the time interval required till the first analgesic dose
to reach a numeric rating scale NRS Pain score ≥4
Time frame: the first 24 hours
total pethidine dose received
record total dose of pethidine
Time frame: total pethidine dose received in 24 hours
mean blood pressure
hemodynamics
Time frame: will be recorded 5 minutes before injection, 5 minutes after injection then every 20 minutes intra-operatively and at intervals of 1, 2, 4, 6, 12, 18 and 24 hours postoperatively.
heart rate changes
hemodynamics
Time frame: will be recorded 5 minutes before injection, 5 minutes after injection then every 20 minutes intra-operatively and at intervals of 1, 2, 4, 6, 12, 18 and 24 hours postoperatively.
Incidence of side effects
occurrence of nausea and vomiting
Time frame: record any side effect over 24 hours
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