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The aim of this study is to evaluate the effect of adding Dexmedctomidinc as adjuvant to Bubivacaine in Ultrasound-Guided Quadratus Lumborum Block for Postoperative Analgesia in Laparoscopic Cholecystectomy.
When compared to conventional surgery, laparoscopic cholecystectomy is less invasive and leads to less postoperative pain. However, the postoperative pain following laparoscopic cholecystectomy consists of both somatic and visceral components with pain originating from port entry' wounds, gallbladder resection and abdominal insufflation that leads to peritoneal distention and peritoneal damage.
Quadratus lamborum block (QLB) is abdominal truncal block that provides both somatic and visceral analgesia for both upper and lower abdominal surgical procedures, It was first introduced by Blanco.Currently There are 4 approaches described for QLB: lateral, posterior, anterior and intramuscular. Transmuscular (anterior) QLB Type 3 block involves injection in the plane between the psoas major (PM) and the QL muscles studies have reported spread of the injectate to the thoracic paravertebral space, as well as the spinal nerve which runs anterior to the QL muscle
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Bupivacaine group | Active Comparator | Patients received general anesthesia and bilateral ultrasound guided transmuscular quadratus lumborum block with (20 ml bupivacaine 0.25%) |
|
| Bupivacaine and Dexmedetomidinc group | Experimental | Patients received general anesthesia and bilateral ultrasound guided transmuscular quadratus lumborum block with (20ml Bupivacaine 0.25%) + (Dexmedetomidine I mic/kg) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bupivacaine | Drug | Patients received general anesthesia and bilateral ultrasound guided transmuscular quadratus lumborum block wilh (20 ml bupivacaine 0.25%). |
|
| Measure | Description | Time Frame |
|---|---|---|
| Total morphine consumption | Intravenous morphine 2 mg given when numerical rating scale equal or above 4 as rescue analgesia | 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Mean arterial blood pressure | Mean arterial blood pressure was recorded before the block (base-line value), after skin incision by 5,15,30 minutes, and at the end of the operation. | At the end of the operation(Up to 48 min). |
| Heart rate |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tanta University | Tanta | ElGharbia | 31527 | Egypt |
The data was available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data was available upon a reasonable request from the corresponding author.
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| Bupivacaine and Dexmedetomidinc) group | Drug | Patients received general anesthesia and bilateral ultrasound guided transmuscular quadratus lumborum block with (20ml Bupivacaine 0.25%) + (Dexmedetomidine Imic/kg) |
|
Heart rate was recorded before the block (base-line value), after skin incision by 5,15,30 minutes, and at the end of the operation.
| At the end of the operation (Up to 48 min). |
| lntraoperative fentanyl consumption | Additional fentanyl dosages of 0.5 µg/kg IV was administered if heart rate or mean arterial blood pressure elevated more than 20% of the baseline (after exclusion of other causes than pain). | lntraoperatively |
| Degree of pain score | Postoperative pain was assessed by the numerical rating scale (NRS; 0 no pain while 10 is the maximum pain) immediately after discharge to the PACU and ward at 6, 12, 18, 24 hours. | 24 hours postoperatively |
| Time to the first request for the rescue analgesia | Time to the first request for the rescue analgesia (time from end of surgery to first dose of morphine administrated).IV morphine 2mg was given when NRS equal or above 4. | 24 hours postoperatively |
| Incidence of Complication | Complication such as bradycardia, hypotension, nausea, vomiting, Pruritis, respiratory depression, or any other complication. | 24 hours postoperatively |
| ID | Term |
|---|---|
| D002045 | Bupivacaine |
| D044382 | Population Groups |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
| D003710 | Demography |
| D011154 | Population Characteristics |
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