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This study aims to compare the effects of the external oblique and rectus abdominis plane (EXORA) block and the quadratus lumborum block (QLB) on postoperative analgesia in patients undergoing laparoscopic cholecystectomy (LC).
Laparoscopic cholecystectomy (LC) is a proven, gold standard surgical procedure for the management of gallbladder stones.
The quadratus lumborum block (QLB) is a regional block that would appear to be similar to the posterior TAP block, although the drug injection area is deeper and more dorsal than the transverse abdominal aponeurosis.
The external oblique and rectus abdominis plane (EXORA) block is an emerging technique providing a sensory block to the anterolateral abdominal wall.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EXORA group | Experimental | Patients will receive an external oblique and rectus abdominis plane (EXORA) block using 20ml of bupivacaine 0.25%. |
|
| QLB group | Experimental | Patients will receive a quadratus lumborum block (QLB) using 20ml of bupivacaine 0.25%. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| External oblique and rectus abdominis plane block | Other | Patients will receive an external oblique and rectus abdominis plane (EXORA) block using 20ml of bupivacaine 0.25%. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Time to the 1st rescue analgesia | Time to the first request for the rescue analgesia (time from the end of surgery to first dose of morphine administrated). | 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Total morphine consumption | Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) > 3 to be repeated after 30 min if pain persists until the NRS < 4. | 24 hours postoperatively |
| Intraoperative fentanyl consumption |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tanta University | Tanta | El-Gharbia | 31527 | Egypt |
The data will be 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 will be available upon a reasonable request from the corresponding author.
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| Quadratus lumborum block | Other | Patients will receive a quadratus lumborum block (QLB) using 20ml of bupivacaine 0.25%. |
|
Additional fentanyl bolus dosages of 0.5 µg/kg IV will be administered if heart rate or mean arterial blood pressure elevated more than 20% of the baseline (after exclusion of other causes than pain). |
| Intraoperatively |
| Degree of pain | Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed at PACU, 2, 4, 6, 8, 12, 18 and 24 h postoperatively. | 24 hours postoperatively |
| Incidence of adverse events | Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, pruritus, or any other complication. | 24 hours postoperatively |