This study aims to compare the effects of the external oblique and rectus abdominis plane (EXORA) block and the quadratus lumborum block (QLB) on postoperative analgesia in patients undergoing laparoscopic cholecystectomy (LC).
Laparoscopic cholecystectomy (LC) is a proven, gold standard surgical procedure for the management of gallbladder stones. The quadratus lumborum block (QLB) is a regional block that would appear to be similar to the posterior TAP block, although the drug injection area is deeper and more dorsal than the transverse abdominal aponeurosis. The external oblique and rectus abdominis plane (EXORA) block is an emerging technique providing a sensory block to the anterolateral abdominal wall.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
80
Patients will receive an external oblique and rectus abdominis plane (EXORA) block using 20ml of bupivacaine 0.25%.
Patients will receive a quadratus lumborum block (QLB) using 20ml of bupivacaine 0.25%.
Tanta University
Tanta, El-Gharbia, Egypt
RECRUITINGTime to the 1st rescue analgesia
Time to the first request for the rescue analgesia (time from the end of surgery to first dose of morphine administrated).
Time frame: 24 hours postoperatively
Total morphine consumption
Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) \> 3 to be repeated after 30 min if pain persists until the NRS \< 4.
Time frame: 24 hours postoperatively
Intraoperative fentanyl consumption
Additional fentanyl bolus dosages of 0.5 µg/kg IV will be administered if heart rate or mean arterial blood pressure elevated more than 20% of the baseline (after exclusion of other causes than pain).
Time frame: Intraoperatively
Degree of pain
Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at PACU, 2, 4, 6, 8, 12, 18 and 24 h postoperatively.
Time frame: 24 hours postoperatively
Incidence of adverse events
Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, pruritus, or any other complication.
Time frame: 24 hours postoperatively
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