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Evaluation of the effectiveness of Anterior Quadratus Lumborum Block at the lateral supra-arcuate ligament under laparoscopic direct vision compared to local infiltration anesthesia for postoperative analgesia after laparoscopic renal surgery in patients.A randomized controlled trial involving 66 patients undergoing laparoscopic renal surgery will assign them randomly to an experimental group or a control group.The patients in experimental group will receive Anterior Quadratus Lumborum Block at the lateral supra-arcuate ligament under laparoscopic direct vision.The patients in control group will receive local infiltration anesthesia.The primary outcome measure is the cumulative consumption of intravenous morphine equivalents at postoperative 24 hours.The secondary outcomes include the cumulative consumption of intravenous morphine equivalents at postoperative 2, 4, 6, 12 and 48 hours, Numeric Rating Scale(NRS) score at rest and during activity (coughing) at postoperative 2, 6, 24 and 48 hours, Global Comfort Questionnaire(GCQ) Comfort Status Scale Score, Quality of Recovery-15(QoR-15) Postoperative Recovery Scale Score, time of the first press on the Patient-Controlled Analgesia pump, nausea, vomiting, skin itching, drowsiness, or other adverse reactions, regional anesthesia-related complications such as local anesthetic toxicity and length of postoperative hospital stay after surgery.
The patients were 1:1 randomly assigned into groups by a clinical researcher not involved in the clinical procedures or data collection. The random numbers were generated by R studio 4.1.0 (R studio, Boston, MA, USA) software in a 1:1 ratio, with a block size of 8 for each group. The generated random numbers were sealed in opaque envelopes with sequential numbers. On the day of surgery, the envelope was opened by the protocol executor according to the recruitment order before the induction of general anesthesia.Data collection is in the charge of special personnel, and Case Report Form shall be filled in timely after data collection. At the same time, the electronic database was edited by Excel, and the electronic database was entered timely after filling in the paper Case Report form.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| QLB-LSAL | Experimental | The patient received Anterior Quadratus Lumborum Block at the lateral supra-arcuate ligament under laparoscopic direct vision. |
|
| LA | Active Comparator | The patient received local infiltration anesthesia. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Anterior Quadratus Lumborum Block at the lateral supra-arcuate ligament under laparoscopic direct vision | Procedure | The urologists find the inner arcuate ligament. The scalp needle is inserted from the midpoint of the lower edge of the inner or outer arcuate ligament towards the head to the dorsal side of the diaphragm. After withdrawing without blood, air, or cerebrospinal fluid, 2 ml of normal saline is first administered to observe the fluid spreading towards the head Then, 20 ml of 0.375% ropivacaine hydrochloride injection is administered. |
| Measure | Description | Time Frame |
|---|---|---|
| intravenous morphine equivalents | The cumulative consumption of intravenous morphine equivalents | Postoperative 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| intravenous morphine equivalents | The cumulative consumption of intravenous morphine equivalents | Postoperative 2, 4, 6, 12 and 48 hours |
| Numeric Rating Scale | Numeric Rating Scale(NRS) score at rest and during activity (coughing),the pain score is from 0-10,0 is no pain,10 is the most. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Lina Yu, doctor | Contact | +86 13958033387 | zryulina@zju.edu.cn |
| Name | Affiliation | Role |
|---|---|---|
| Lina Yu, doctor | 2nd Affiliated Hospital, School of Medicine, Zhejiang University, China | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Second affiliated Hospital School of Medicine,Zhejiang University | Recruiting | Hangzhou | Zhejiang | China |
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|
| Local infiltration anesthesia | Procedure | The urologists give local infiltration anesthesia with 20 ml of 0.375% ropivacaine hydrochloride injection. |
|
| postoperative 2, 6, 24 and 48 hours |
| Global Comfort Questionnaire | Global Comfort Questionnaire(GCQ) Kolcaba Scale Score,it includes 28 questions,1 is not agree with,4 is very agree with,the total score is 114. | Preoperative and postoperative 24 hours |
| Quality of Recovery-15 | Quality of Recovery-15(QoR-15) Postoperative Recovery Scale Score,it includes 15 questions,0 is the worst,10 is the best,total score is 150. | Postoperative 24 hours |
| Time of the first press on Patient-Controlled Analgesia | Time of the first press on the Patient-Controlled Intravenous Analgesia pump | Postoperative 48 hours |
| adverse reactions | Nausea, vomiting, skin itching, drowsiness, and other adverse reactions | Postoperative 72 hours |
| Regional anesthesia-related complications | Regional anesthesia-related complications such as local anesthetic toxicity | Postoperative 72 hours |
| Length of hospital stay | Length of postoperative hospital stay | Postoperative 10 days |
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D000772 | Anesthesia, Local |
| ID | Term |
|---|---|
| D000765 | Anesthesia, Conduction |
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
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