Effect of Pre-incisional Ultrasound-guided Quadratus Lumborum Block on Perioperative Analgesia and Inflammatory Responses in Transperitoneal Laparoscopic Nephrectomy: A Single-blinded, Randomised Control Trial

Dita Aditianingsih, Besthadi Sukmono, Erika Adiwongso, Chaidir Mochtar

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review

Abstract

A Quadratus lumborum (QL) block produces an effective lower abdominal surgery perioperative analgesia, which has been reported to improve perioperative pain intensity and inflammatory responses. This prospective randomised-control study evaluates the efficacy of a pre-incisional ultrasound-guided QL block in providing perioperative analgesia following a transperitoneal laparoscopic nephrectomy. Forty-four adult patients were randomly assigned into the control group or QL block group. Intraoperative fentanyl, post-operative Numerical Rating Scale (NRS) at rest and during movement and additional tramadol in the first 24 hours were recorded. Blood samples for interleukin-6 (IL-6) and hemodynamic profiles were recorded after anaesthesia induction, after two hours of surgery and two hours post-operation. The QL block group had lower intraoperative fentanyl (P < 0.05), lower post-operative NRS at rest and during movement (P < 0.001), lower IL-6 level (P < 0.05) and lower additional post-op erative tramadol demand with a relative risk of 3.00 (1.43–6.29, P < 0.05). The intraoperative hemodynamic profiles and after-surgery were significantly changed, compared to the baseline in the control group (P < 0.001), while the QL block group showed more stable profiles (P > 0.05). The pre-incisional QL block with 0.25% bupivacaine reduced the need for intraoperative opioid, showed more stable intraoperative hemodynamic changes and lowered inflammatory response, post-operative pain and the need for additional opioids following transperitoneal laparoscopic nephrectomy.
Original languageEnglish
Title of host publicationProceedings of the 4th Annual International Conference and Exhibition on Indonesian Medical Education and Research Institute The 4th ICE on IMERI
Pages26-32
DOIs
Publication statusPublished - 2019
EventThe annual International Conference and Exhibition on Indonesian Medical Education and Research Institute - Jakarta, Indonesia
Duration: 3 Nov 20197 Nov 2019

Conference

ConferenceThe annual International Conference and Exhibition on Indonesian Medical Education and Research Institute
Period3/11/197/11/19

Keywords

  • Quadratus Lumborum Block
  • Laparoscopic Nephrectomy
  • Pre-incisional

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