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The classical transmuscular qudratus lumborum block(TMQLB) described by Borglum aims to provide lower thoracic paravertebral space(PVS) and sympathetic blockade by injecting local anesthetics between QL and PM muscle at the L3-L4 vertebral level using a transverse scan, posterior-anterior, in-plane approach. Recently, a paramedian sagittal oblique(TMQLB) approach has been introduced to facilitate cranial spread by injecting the local in a caudal to cranial direction. Currently, there are no data comparing the two techniques mentioned above with regards to extent of spread for PVS. Our objective is to investigate the extent of cranial dermatomal spread of TMQLB when equal dosage(ml/kg) of local anesthetic are injected with the transverse versus an modified paramedian sagittal approach for patients undergoing laparoscopic adrenalectomy. In addition, the investigators wish to compare the performance time, caudal dermatomal spread of TMQLB and postoperative analgesia effect.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| transverse TMQLB | Active Comparator | Patients in this group will receive the transmuscular quadratus lumborum block before surgery using the transverse scan, in-plain, posterior to anterior approach. 0.6ml 0.375% ropivocaine was injected when the correct needle location is confirmed. |
|
| paramedian sagittal TMQLB | Experimental | Patients in this group will receive the transmuscular quadratus lumborum block before surgery using the para-sagittal scan, in-plain, caudal to cephalic approach.0.6ml 0.375% ropivocaine was injected when the correct needle location is confirmed. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| transverse scan, in-plane, posterior-anterior TMQLB | Procedure | The patients will receive the transmuscular quadratus lumborum block(TMQLB) before surgery using the transverse scan, in-plain, posterior to anterior approach. 0.6ml/kg 0.375% ropivocaine is injected when the correct needle location is confirmed. |
| Measure | Description | Time Frame |
|---|---|---|
| Cephalic sensory dermatomal spread | 20 minutes after block performance |
| Measure | Description | Time Frame |
|---|---|---|
| Time to performance of procedure | Duration of procedure | |
| Total sensory dermatomal spread | 20 minutes after block performance | |
| Incidence of complication |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Xulei CUI | Peking Union Medical College Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking Union Medical College Hospital | Beijing | China |
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| paramedian sagittal scan, in-plane, caudal-cranial TMQLB | Procedure | The patients will receive the transmuscular quadratus lumborum block(TMQLB) before surgery using the paramedic sagittal scan, in-plain, caudal-cephalic approach.0.6ml/kg 0.375% ropivocaine is injected when the correct needle location is confirmed. |
|
| Within 48hours after surgery |
| Caudal sensory dermatomal spread | 20 minutes after block performance |
| cumulative rate of rescue analgesics usage | At 0,2,4,8,12,24,48 hours after surgery |
| NRS pain scores | patients will evaluate their pain intensity with the numerical rating scale (NRS), where 0 indicates no pain, and 10 indicates the most severe pain. | At 0,2,4,8,12,24,48hours after surgery |