Oblique Subcostal Transversus Abdominis Plane Block Versus Transmuscular Quadratus Lumborum Block for Pain Management in Laparoscopic Gynecological Surgery
Study Details
Study Description
Brief Summary
Laparoscopic gynecological surgery causes postoperative pain.The primary objective of this study is to compare the effect of ultrasound (US)-guided oblique subcostal transversus abdominis plane block (OSTAP) on 24-hour total analgesic consumption with transmuscular quadratus lumborum block (TQLB).
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Patients between the ages of 18-65, who will undergo laparoscopic gynecological surgery, American Society of Anesthesiologists (ASA) class I-II-III, Body Mass Index (BMI) in the range of 18-25 kg/m², and who will use 3 or 4 trocar for surgery will be included in the study. Patients will be randomized into two groups. OSTAP block will be performed for OSTAPB group and TQL block will be performed for TQLB group. Patients will be administered postoperative 4x500 mg iv paracetamol as needed (if Numerical rating scale (NRS) score is 4 or higher). If the NRS score remains at 4 or higher 30 minutes after paracetamol administration, 1 mg/kg iv tramadol will be administered as a rescue analgesic (with a daily maximum dose of 400 mg). The primary outcome is to compare the total analgesic consumption within the first 24 hours after surgery. The secondary outcome is to compare the time to the first postoperative analgesic requirement, NRS scores at rest and on movement, and assess the impact of these two blocks on the quality of recovery using the QOR-15 scale
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Active Comparator: Group OSTAP The investigator will perform oblique subcostal transversus abdominis plane block to that patient group for postoperative analgesia |
Procedure: Oblique Subcostal Transversus Abdominis Plane Block
The investigator will perform oblique subcostal transversus abdominis plane block to that patient group for postoperative analgesia
|
| Active Comparator: Group TQLB The investigator will perform transmuscular quadratus lumborum block to that patient group for postoperative analgesia |
Procedure: Transmuscular Quadratus Lumborum Block
The investigator will perform transmuscular quadratus lumborum block to that patient group for postoperative analgesia
|
Outcome Measures
Primary Outcome Measures
- Postoperative 24 hours total analgesic consumption [24 hours postoperatively]
The primary outcome is to compare the total consumption of paracetamol and tramadol within the first 24 hours after surgery.
Secondary Outcome Measures
- The time to the first analgesic requirement, NRS scores and QOR-15 scores of the patients [24 hours postoperatively]
The secondary outcome is to compare the time to the first postoperative analgesic requirement, NRS scores at 0, 30th min and 1, 2, 6, 12, 18, 24th hours at rest and on movement, and assess the impact of these two blocks on the quality of recovery using the QoR-15 scale. A numerical rating scale (NRS) requires the patient to rate their pain on a defined scale. For example, 0-10 where 0 is no pain and 10 is the worst pain imaginable. The QoR-15 scale is a unidimensional measurement of quality of recovery measured in five domains: physical comfort, pain, physical independence, psychological support, and emotional state. The QoR-15 scale provides a score ranging from 0 to 150, with a high score indicating a good quality of recovery.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Ages of 18-65
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Patients who will undergo laparoscopic gynecological surgery
-
ASA I-II-III patients
-
Body Mass Index (BMI) in the range of 18-25 kg/m²
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Patients who will undergo surgery using 3 or 4 trocars
Exclusion Criteria:
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ASA IV-V
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Patients with a known or suspected allergy to local anesthetics
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Coagulopathy
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Injection site infection
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Severe neurological or psychiatric disorders
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Severe cardiovascular disease
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Liver failure
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Kidney failure (glomerular filtration rate <15 ml/min/m²)
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Chronic opioid use (>6 months)
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Surgical durations less than 45 minutes or greater than 120 minutes
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Bursa Uludag University Faculty of Medicine | Bursa | Turkey | 16059 |
Sponsors and Collaborators
- Uludag University
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- UludagU-KCebeci-001