A Comparison of the Effects of TAP (Transversus Abdominis Plane) Block and QLB-1 (Lateral Quadratum Lumbarum) Block on Postoperative Pain and Opioid Consumption in Laparoscopic Cholecystectomy

Status: Recruiting
Location: See location...
Intervention Type: Procedure
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Laparoscopic cholecystectomy is associated with less pain than open surgery and a shorter recovery time. While the type of pain experienced after laparoscopy differs from that experienced after laparotomy, it is predominantly parietal pain (originating from the abdominal wall). However, patients also report visceral pain due to pneumoperitoneum. Various analgesic procedures, including nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and regional anesthesia techniques, are employed as part of multimodal analgesia for postoperative pain. Regional anesthesia techniques for abdominal surgery include thoracic epidural analgesia, paravertebral block, and transversus abdominis plane (TAP) block. TAP block, one of the truncal blocks, has been utilized in numerous studies in the literature for the management of postoperative pain following abdominal surgery. TAPB is a nerve block technique that blocks sensory nerves by injecting local anesthetic into the plane between the transverse abdominis and internal oblique muscles. Although TAPB can effectively relieve somatic pain in patients undergoing minimally invasive laparoscopic surgery, it may not be suitable for visceral analgesia. Another truncal block that has gained recent attention is the Quadratus Lumborum Block (QLB). QLB is another nerve block technique that blocks sensory nerves by injecting local anesthetic into the interfascial plane between the quadratus lumborum and psoas muscles. QLB offers several advantages, including the ability to provide both somatic and visceral analgesia. This comprehensive approach can result in more effective postoperative analgesia during laparoscopic surgical procedures. Additionally, the use of TAPB or QLB may reduce opioid consumption, potentially improving analgesia in laparoscopic surgeries. The quadratus lumborum muscle can be blocked in four different ways: lateral, posterior, anterior, and intramuscular. In our study, the lateral quadratus lumborum block was the preferred approach. Opioids are the most commonly used narcotic analgesics for postoperative pain. Patients often require opioids for pain relief in the perioperative period, especially in abdominal surgery. However, the use of opioids can lead to a variety of side effects, including excessive sedation, postoperative nausea and vomiting, urinary retention, constipation, hyperalgesia, respiratory depression and immunosuppression. Opioids may have various effects on immune function, including modulation of cytokines, interaction with immune cells, affecting the neuroendocrine system and vascular permeability. These effects may contribute to postoperative complications such as infections and delayed wound healing due to increased inflammatory response. They may also prolong hospitalization. In order to reduce postoperative opioid consumption and opioid-related side effects, ultrasound-guided trunk block techniques are being developed in abdominal surgeries. Currently, ultrasound-guided multimodal analgesia techniques are widely used. Transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) are effective analgesic methods employed in conjunction with multimodal analgesia techniques during anesthesia. The objective of this study was to compare the effects of TAPB (transversus abdominis plane block) and QLB-1 (lateral quadratus lumborum block), which are frequently used in our clinic, on postoperative pain scores and the need for additional analgesics. Secondary objectives included postoperative opioid consumption, nausea and vomiting, hospital stay, and patient and surgeon satisfaction.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 64
Healthy Volunteers: t
View:

• \- Consenting patients,

• He's having a laparoscopic cholecystectomy,

• ASA-I-II,

• Between the ages of 18 and 64,

• No history of anticoagulant or antiaggregant drug use,

• Regional anesthesia is not contraindicated and the anesthesiologist is deemed appropriate for regional anesthesia,

• Under general anesthesia and undergoing laparoscopic surgery,

• Oriented and cooperative patients,

Locations
Other Locations
Turkey
Başakşehir Çam ve Sakura Şehir Hastanesi
RECRUITING
Istanbul
Contact Information
Primary
Emine OZCAN, MD
dr.emine3419@gmail.com
+905301592856
Backup
Funda GUMUS OZCAN, Prof.
fgumus@hotmail.com
+905305245654
Time Frame
Start Date: 2024-12-25
Estimated Completion Date: 2025-12-28
Participants
Target number of participants: 60
Treatments
Active_comparator: TAP (Transversus Abdominis Plan) Block
A bilateral TAP or QLB-1 block will be performed. This block is a standard procedure in our hospital for the management of postoperative pain.
Experimental: QLB-1 (Lateral Quadratum Lumborum ) Block
Investigation of the efficacy of QLB-1 block compared to TAP block.
Sponsors
Leads: Başakşehir Çam & Sakura City Hospital

This content was sourced from clinicaltrials.gov

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