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To analyze the relationship of anterior subcostal quadratus lumborum (QL) block compared with control block on the incidence of chronic neuropathic pain at three months post-laparoscopic retroperitoneal living kidney donor.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Quadratus Lumborum Block | Experimental |
| |
| Quadratus Lumborum Sham Block | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| injection of local anesthesia solution | Drug | Injection of 30 mL local anesthetic solution bupivacaine 0.25% |
|
| Measure | Description | Time Frame |
|---|---|---|
| Neuropathic Pain Incidence: Neuropathic Pain in 4 Questionnaire | Pain that develops after a surgical procedure in the area of surgery and its radiation, persists for at least 3 months after surgery, other causes of pain (e.g. infection and history of malignancy) or pre-existing pain have been excluded. Total score: 10 Score ≤ 4 = no pain developed Score ≥ 4 = pain developed | 3 months after intervention |
| Neuromodulation Parameter: Degree of functional interference using Behavioral Pain Interference (BPI) | The degree of pain that develops after a surgical procedure in the area of surgery and its radiation, persisting for at least 3 months after surgery, other causes of pain (eg infection and history of malignancy) or pre-existing pain have been excluded. Behavioral Pain Interference (BPI) questionnaire based on the average of questions 4, 5, and 6
| At 3 months after intervention |
| Chronic Pain Severity: Leeds Assesment of neuropathic symptoms and sign (LANSS) scale | A measuring tool used to assess neuropathic pain and provides information to differentiate nociceptive pain from neuropathic pain. Total score: 24 <12: Not neuropathic >12: Neuropathic pain | At 3 months after intervention |
| Neuroinflammation Parameter: Serum Concentration of Toll-like Receptor 4 (TLR4) | Transmembrane receptors in the innate immune system. Units: ng/mL | At 3 months after intervention |
| Neuroinflammation Parameter: Serum Concentration of Calcitonin gene-related peptide (CGRP) | Neuropeptides that play a role in pain transmission and vasodilation Unit: pg/mL | At 3 months after intervention |
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Inclusion Criteria:
Living kidney donor candidate patients aged 18-65 years Patients with ASA physical status assessment 1-3 Patients are willing to be research subjects.
Exclusion Criteria:
The patient had a history of preoperative laparoscopic kidney donor surgery.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Raden B Sukmono | Contact | +628129508625 | Raden.besthadi01@ui.ac.id |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| RSUPN Cipto Mangunkusumo | Jakarta Pusat | Jakarta Special Capital Region | 10430 | Indonesia |
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| Injection of normal saline | Drug | Injection of 30 mL normal saline Natrium Chloride (NaCl) 0.9% |
|
| Neuroinflammation Parameter: Serum Concentration of Nerve Growth Factor (NGF) | Neurotrophic factors that play a role in promoting the growth and survival of sensory neurons Unit: pg/mL | At 3 months after intervention |
| Neurophysiology Parameter: Mechanical Detection Threshold (MDt) | Measures the minimum force needed for a person to perceive a light mechanical stimulus, tested using von Frey filaments. Skin contact test for 2 seconds using 1 set of von Frey filaments. The examination is performed in m. trapezius. Unit: mN Lower result means: higher sensitivity (normal or hypersensitivity) Higher result means: Reduced sensitivity, could indicate hypoesthesia or nerve damage | At 3 months after intervention |
| Neurophysiology: Mechanical Pain Threshold (MPt) | Accurate measurement of pain threshold. Skin contact test using repeated pinpricks at the same location. Comparative assessment of initial pain scale with pain scale after repeated stimulation. Examination is performed at m. trapezius. Unit: Numerical Rating Scale (NRS) from 1 to 10 Lower NRS: higher sensitivity to pain Higher NRS: lower sensitivity to pain | At 3 months after intervention |
| Neurophysiology Parameter: Pressure Pain Threshold (PPt) | Pain tolerance examination. Pressure assessment in kgf/cm2 units where the patient complains of pain according to the stimulus given. The examination is carried out in m. trapezius Units: kgf/cm2. Lower PPT: Increased pain sensitivity Higher PPT: Decreased pain sensitivity | At 3 months after intervention |
| Neurophysiology Parameter: Mechanical Temporal Summation of Pain (MTSP) | Evaluates central sensitization by applying repeated light mechanical stimuli and rating how pain builds up over time. Pressure assessment in kgf/cm2 units where the patient complains of pain according to the stimulus given. The examination is carried out in m. trapezius. Units: Verbal Numeric Scale (VNS) from 1 to 10 Higher MTSP score: Indicates central sensitization Lower MTSP score: Normal pain processing | At 3 months after intervention |
| Neuromodulation Parameter: Serum Concentration of beta-Endorfin | Neuropeptide produced in the anterior pituitary and brain, as an endogenous opioid. Units: pg/mL | At 3 months after intervention |
| ID | Term |
|---|---|
| D059350 | Chronic Pain |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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