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

2019

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-operative 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.

Paper Citation

in Harvard Style

Aditianingsih D., Sukmono B., Adiwongso E. and Mochtar C. (2019). 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.In Proceedings of the 4th Annual International Conference and Exhibition on Indonesian Medical Education and Research Institute - Volume 1: The 4th ICE on IMERI, ISBN 978-989-758-433-6, pages 26-32. DOI: 10.5220/0009387900260032

in Bibtex Style

@conference{the 4th ice on imeri19,
author={Dita Aditianingsih and Besthadi Sukmono and Erika Adiwongso and Chaidir Mochtar},
title={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},
booktitle={Proceedings of the 4th Annual International Conference and Exhibition on Indonesian Medical Education and Research Institute - Volume 1: The 4th ICE on IMERI,},
year={2019},
pages={26-32},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0009387900260032},
isbn={978-989-758-433-6},
}

in EndNote Style

TY - CONF

JO - Proceedings of the 4th Annual International Conference and Exhibition on Indonesian Medical Education and Research Institute - Volume 1: The 4th ICE on IMERI,
TI - 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
SN - 978-989-758-433-6
AU - Aditianingsih D.
AU - Sukmono B.
AU - Adiwongso E.
AU - Mochtar C.
PY - 2019
SP - 26
EP - 32
DO - 10.5220/0009387900260032