Erector Spinae Plane Block Versus Quadratus Lumborum Block for Postoperative Analgesia After Laparoscopic Resection of Colorectal Cancer.

NCT05574283 | Unknown

• 1 other identifier: FMBSUREC/11092022/Negm
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Colorectal cancers are one of the leading causes of cancer-related mortality, and the incidence is increasing day by day. For this reason, colorectal cancer surgery and postoperative analgesia have gained more importance in recent years.Although laparoscopic surgery is less invasive, it can still generate moderate to severe acute postoperative pain.For a long time, opioids have played a major role in postoperative analgesia, but heavy use of these drugs will cause adverse reactions such as nausea, vomiting and enteroparalysis, which is not conducive to rapid recovery after surgery Therefore, it is critical to developing a more effective regional analgesic technique for patients undergoing abdominal surgery . Erector spinae plane block (ESPB) is a novel interfascial plane block technique that was firstly described in 2016. It involves injecting local anesthetic into the plane between the deep fascia of the erector spinae muscle and the vertebral transverse process under ultrasound guidance to relieve pain in the thoracoabdominal region .The quadratus lumborum block (QLB) is a new posterior abdominal trunk block which produces analgesic effects through local anesthetic that covers thoracolumbar fascia and thoracic paravertebral space. Based on the injection position and approach, there are 3 QLB techniques: lateral approach, posterior approach and anterior approach. The anterior transmuscular quadratus lumborum block (TQLB) is a truncal block (ventral rami of T7- L2) that produces its analgesic effect by blocking the thoracic sympathetic trunk, the ventral rami of lower spinal nerves, the sympathetic fibers and mechanoreceptors within the thoracolumbar fascia, and the celiac ganglion by spread via the splanchnic nerves .

Conditions

Pain, Postoperative

Outcome Measures

Primary Outcomes (1)

• Total dose of rescue analgesia that was consumed in the first 24 hours postoperatively.

  Total dose of rescue analgesia (nalbuphine) , that was consumed in the first 24 hours postoperatively,if patient visual analogue score more than or equal 3.

  First 24 hours postoperatively. Starting immediately after surgery up to 24 hours.

Secondary Outcomes (1)

• 1st time to rescue analgesic (min).

  First 24 hours postoperatively. Starting from the end of the surgery up to 24 hours..

Study Arms (2)

ESPB group

EXPERIMENTAL

ESPB group: 30 patients will receive bilateral ultrasound-guided erector spinae plane block using 20 ml of bupivacaine 0.25% with 4 mg dexamethasone for each side.

Procedure: Erector spinae plane block and transmuscular quadratus lumborum block

TQLB group

EXPERIMENTAL

TQLB group: 30 patient will receive bilateral ultrasound-guided transmuscular quadratus lumborum block using 20 ml of bupivacaine 0.25% with 4 mg dexamethasone for each side.

Procedure: Erector spinae plane block and transmuscular quadratus lumborum block

Interventions

Erector spinae plane block and transmuscular quadratus lumborum block PROCEDURE

All blocks were performed after securing the airway before the start of surgery. ESPB group will receive bilateral ultrasound-guided erector spinae plane block using 20 ml of bupivacaine 0.25% with 4 mg dexamethasone for each side. TQLB group will receive bilateral ultrasound-guided transmuscular quadratus lumborum block using 20 ml of bupivacaine 0.25% with 4 mg dexamethasone for each side

ESPB group; TQLB group

Eligibility Criteria

• Age: 35 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• age between 35 and 75 years.
• patient scheduled for laparoscopic resection of colorectal cancer.
• American Society of Anesthesiologists classification of physical status \< IV.
• body's mass index (BMI) ≤ 35 kg/m2.

You may not qualify if:

• Refusal of the patient.
• known hypersensitivity to any study medication.
• Chronic opioid use or chronic pain patient.
• Liver insufficiency (defined as a serum bilirubin ≥ 34 μmol/l, albumin ≤ 35 g/dl, INR ≥ 1.7).
• Renal insufficiency (defined as a glomerular filtration rate \< 44 ml/min).
• MOrbid obesity (defined as a BMI \> 35 kg/m2).
• Obstructive sleep apnea syndrom.

Sponsors & Collaborators

• Beni-Suef University: lead

Study Sites (1)

Benisuef university

Banī Suwayf, 11311, Egypt

RECRUITING

Related Publications (1)

• Mahmoud Fakhry D, ElMoutaz Mahmoud H, Yehia Kassim D, NegmEldeen AbdElAzeem H. Erector Spinae Plane Block versus Quadratus Lumborum Block for Postoperative Analgesia after Laparoscopic Resection of Colorectal Cancer: A Prospective Randomized Study. Anesthesiol Res Pract. 2024 Mar 18;2024:6200915. doi: 10.1155/2024/6200915. eCollection 2024.

  PMID: 38529324 DERIVED

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Officials

• hebatullah Negmeldeen, lecturer

  Beni-Suef University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

HEBATULLAH Negmeldeen, lecturer

CONTACT

00201150323132; hebanegm1899@gmail.com

Dina Kasem, A.P

CONTACT

01005257521; dinayk31@yahoo.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: lecturer of anaesthesia

Study Record Dates

• First Submitted: October 4, 2022
• First Posted: October 10, 2022
• Study Start: October 4, 2022
• Primary Completion: October 4, 2023
• Study Completion: October 4, 2023
• Last Updated: October 10, 2022

Record last verified: 2022-10

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

EG (1)