Impact of preoperative quadratus lumborum block on postoperative opioid consumption after laparoscopic hysterectomy: a double-blind randomized controlled trial.

IF 1.5 Q4 CLINICAL NEUROLOGY
Kathryn Edmonds, Kiley Hunkler, Christopher Creedon, Sara Drayer, Scott Endicott, Kathryn Eliasen, Candice Jones-Cox
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引用次数: 0

Abstract

Background: Gynecologic enhanced recovery after surgery (ERAS) pathways have been developed to reduce postoperative narcotic use through multimodal pain management. While incisional injection of local anesthetic is standard practice, regional nerve blockades using liposomal agents are emerging as a promising adjunct technique for post-laparoscopy pain. Current data are conflicting regarding the benefits of regional nerve blocks on postoperative pain after laparoscopic hysterectomy.

Objectives: To determine the impact of preoperative quadratus lumborum (QL) block on postoperative pain following laparoscopic hysterectomy. Our primary outcomes will be intraoperative and immediate postoperative opioid use (within 24 hours). Secondary outcomes will include pain scores, functional impact of pain, and postoperative complications.

Study design: This is a prospective, double-blind, randomized-controlled trial comparing opioid use in women undergoing laparoscopic hysterectomy who receive a preoperative QL block to local injection. Seventy-six patients undergoing laparoscopic or robotic hysterectomy will be randomized to the study arm, preoperative QL block with liposomal bupivacaine and intraoperative placebo incisional injection of 0.9% saline, or the control arm, preoperative sham QL block with 0.9% saline and intraoperative incisional injection of 0.25% bupivacaine. Outcomes will be measured at several timepoints: intraoperative, postoperative prior to discharge, and 1, 3, 5, 14 days, and 4-6 weeks postoperatively.

Clinical trial registration: www.clinicaltrials.gov identifier is NCT06709716.

术前腰方肌阻滞对腹腔镜子宫切除术后阿片类药物消耗的影响:一项双盲随机对照试验。
背景:妇科手术后增强恢复(ERAS)途径通过多模式疼痛管理来减少术后麻醉品的使用。虽然切口注射局麻药是标准做法,但使用脂质体药物进行局部神经阻滞正在成为一种有前途的腹腔镜术后疼痛辅助技术。关于局部神经阻滞对腹腔镜子宫切除术后疼痛的益处,目前的数据存在矛盾。目的:探讨术前腰方肌阻滞对腹腔镜子宫切除术后疼痛的影响。我们的主要结果将是术中和术后立即使用阿片类药物(24小时内)。次要结局包括疼痛评分、疼痛对功能的影响和术后并发症。研究设计:这是一项前瞻性、双盲、随机对照试验,比较行腹腔镜子宫切除术的妇女术前接受QL阻滞和局部注射阿片类药物的使用。76名接受腹腔镜或机器人子宫切除术的患者将被随机分配到研究组,术前使用布比卡因脂质体进行QL阻断,术中切口注射0.9%生理盐水安慰剂,或对照组,术前使用0.9%生理盐水进行假QL阻断,术中切口注射0.25%布比卡因。将在几个时间点测量结果:术中、术后出院前以及术后1、3、5、14天和4-6周。临床试验注册:www.clinicaltrials.gov标识符:NCT06709716。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pain management
Pain management CLINICAL NEUROLOGY-
CiteScore
2.90
自引率
5.90%
发文量
62
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