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Effects of Transabdominal Plain Block and Quadratus Lumborum Block After Laparoscopic Hemicolectomy. The pain relief, bowel function and discharge.
This study is proposed to explore the effects of transabdominal plane block and quadratus lumborum block after laparoscopic hemicolectomy.
After laparoscopic hemicolectomy there is a need for good analgesia. When the analgesia is adequate the patients mobilisation, bowel function and discharge is faster. Earlier, epidural block has been used for the analgesia but now the hemicolectomy is laparoscopic procedure and there is no need for central block anymore. Still patients needs opioids after the operation. Because of the opioids side effects, there is a need to find better analgesia methods.
In this study investigators compare peripheral nerve blocks, transabdominal plane and quadratus lumborum, for analgesia after laparoscopic hemicolectomy. Also investigators are comparing these analgesia methods and traditional orally analgesics. Patients receive transabdominal or quadratus lumborum block after induction using ropivacaine 5 mg/ml 20 ml per side. The third group is a control group witch analgesia is taken care with traditional orally analgesics.
After surgery investigators follow postoperative pain, opiate consumption, bowel function, nausea and mobilisation.
Investigators coal is to find if the transabdominal plain block or quadratus lumborum block prefer traditional analgesia methods after laparoscopic hemicolectomy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TAQLA | Experimental | Transabdominal plain block -group. Ropivacaine Hydrochloride Inj 5mg/ml 20 ml perineurally per side. |
|
| TAQLB | Experimental | Quadratus lumborum block -group. Ropivacaine Hydrochloride Inj 5mg/ml 20 ml perineurally per side. |
|
| TAQLC | No Intervention | Control group. Pain relief only with intravenous and peroral drugs. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transabdominal plane block | Procedure | Peripheral nerve block |
| |
| Measure | Description | Time Frame |
|---|---|---|
| First need of opiate | Time after surgery when the patient needs opiate for the first time | 72 hours or until discharge, whichever came first |
| Measure | Description | Time Frame |
|---|---|---|
| Opiate consumption | Total opiate consumption after surgery | 72 hours or until discharge, whichever came first |
| Post operative pain | Numeric rating scale NRS 0-10, verbally description after discharge |
| Measure | Description | Time Frame |
|---|---|---|
| Finnish pain query | This query has first made by the finnish association for the study of pain. It has been modified for this research. It includes questions how pain infects on the daily life (sleeping, exercising, ability to work, concentration et cetera), how often the pain appears and how intense the pain is (scale 0-10). There is a picture of body where patients marks the pain points. | Baseline and 4 week after operation |
Inclusion Criteria:
Adult elective hemicolectomy patients
Exclusion Criteria:
Age under 18 years Complicated diabetes mellitus Lack of finnish language skill and/or co-operation Chronic pain Use of drugs that significantly influences the metabolism of paracetamol or opiate Steroid medication in regular use Significant liver-, lung- or kidney disfunction
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Maija-Liisa Kalliomäki, PhD | Contact | +358 3 311 69424 | maija-liisa.kalliomaki@pshp.fi | |
| Jenni Kanerva, PhD | Contact | +358 3 311 67415 | jenni.kanerva@pshp.fi |
| Name | Affiliation | Role |
|---|---|---|
| Jenni Kanerva, Phd | Tampere University Hospital | Principal Investigator |
| Maija-Liisa Kalliomäki, PhD | Tampere University Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tampere University Hospital | Recruiting | Tampere | 33521 | Finland |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| Quadratus lumborum block |
| Procedure |
Peripheral nerve block |
|
| postoperatively: at 4 hours, at 8 hours,at 12 hours, at 16 hours, at 20 hours, at 24 hours, at 32 hours, 40 hours, at 48 hours, at 56 hours, at 64 hours, at 72 hours, ones per day after discharge for seven days after operation |
| Bowel function | Verbally description: non/gas/function | postoperatively: at 4 hours, at 8 hours,at 12 hours, at 16 hours, at 20 hours, at 24 hours, at 32 hours, 40 hours, at 48 hours, at 56 hours, at 64 hours, at 72 hours, ones per day after discharge for seven days after operation |
| Nausea | Verbally description: yes/no | postoperatively: at 4 hours, at 8 hours,at 12 hours, at 16 hours, at 20 hours, at 24 hours, at 32 hours, 40 hours, at 48 hours, at 56 hours, at 64 hours, at 72 hours, ones per day after discharge for seven days after operation |
| Beck´s depression inventory (BDI) | Baseline and 4 week after operation |
| The State-Trait Anxiety Inventory (STAI) | Baseline and 4 week after operation |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |