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Efficacy of transmuscular quadratus lumborum block in the multimodal regimen for postoperative analgesia after total laparoscopic hysterectomy: A prospective randomised double-blinded study
BACKGROUND AND AIMS: Transmuscular Quadratus Lumborum Block (TQLB) is a novel regional anaesthesia technique, however, its analgesic efficacy as a component of multimodal analgesia (MMA) in Total Laparoscopic Hysterectomy (TLH) is not well studied. The aim of the study was to evaluate the analgesic...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202790/ https://www.ncbi.nlm.nih.gov/pubmed/34211193 http://dx.doi.org/10.4103/ija.IJA_1258_20 |
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author | Jadon, Ashok Ahmad, Asif Sahoo, Rajendra K Sinha, Neelam Chakraborty, Swastika Bakshi, Apoorva |
author_facet | Jadon, Ashok Ahmad, Asif Sahoo, Rajendra K Sinha, Neelam Chakraborty, Swastika Bakshi, Apoorva |
author_sort | Jadon, Ashok |
collection | PubMed |
description | BACKGROUND AND AIMS: Transmuscular Quadratus Lumborum Block (TQLB) is a novel regional anaesthesia technique, however, its analgesic efficacy as a component of multimodal analgesia (MMA) in Total Laparoscopic Hysterectomy (TLH) is not well studied. The aim of the study was to evaluate the analgesic efficacy of TQLB as a component of MMA for postoperative pain in TLH. METHODS: A prospective double-blind randomised controlled study was done after approval from the ethical committee and informed patient consent. After randomisation, 37 patients in Group-Q received 20 ml 0.375% ropivacaine and in Group-C, 37 patients received saline in TQLB bilaterally after TLH surgery. All patients received intravenous patient controlled analgesia (IV-PCA) with fentanyl along with diclofenac 75 mg every 12 h. All the patients were assessed at 2, 4, 6, 8, 12, 18, and 24 hours. The primary outcome was the time to first analgesic request. The secondary outcome measures were total fentanyl consumption in 24 hrs, pain scores during rest and movement, postoperative nausea-vomiting, sedation and complications related to local anaesthetic and TQLB procedure. RESULTS: The mean [standard deviation (SD)] time to first analgesic request was 7.8 (1.5) hours in Group-Q and 3.2 (1.0) hours in Group-C (P < 0.0001). The mean (SD) dose of fentanyl used in 24 hours was 167.3 (44) μg in Group-Q and 226.5 (41.9) μg in Group-C (P < 0.0001). CONCLUSION: The ultrasound-guided TQLB provides effective postoperative analgesia after TLH surgery in a multimodal analgesia approach. It reduces the fentanyl consumption and improves the visual analogue scale (VAS) score. |
format | Online Article Text |
id | pubmed-8202790 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-82027902021-06-30 Efficacy of transmuscular quadratus lumborum block in the multimodal regimen for postoperative analgesia after total laparoscopic hysterectomy: A prospective randomised double-blinded study Jadon, Ashok Ahmad, Asif Sahoo, Rajendra K Sinha, Neelam Chakraborty, Swastika Bakshi, Apoorva Indian J Anaesth Original Article BACKGROUND AND AIMS: Transmuscular Quadratus Lumborum Block (TQLB) is a novel regional anaesthesia technique, however, its analgesic efficacy as a component of multimodal analgesia (MMA) in Total Laparoscopic Hysterectomy (TLH) is not well studied. The aim of the study was to evaluate the analgesic efficacy of TQLB as a component of MMA for postoperative pain in TLH. METHODS: A prospective double-blind randomised controlled study was done after approval from the ethical committee and informed patient consent. After randomisation, 37 patients in Group-Q received 20 ml 0.375% ropivacaine and in Group-C, 37 patients received saline in TQLB bilaterally after TLH surgery. All patients received intravenous patient controlled analgesia (IV-PCA) with fentanyl along with diclofenac 75 mg every 12 h. All the patients were assessed at 2, 4, 6, 8, 12, 18, and 24 hours. The primary outcome was the time to first analgesic request. The secondary outcome measures were total fentanyl consumption in 24 hrs, pain scores during rest and movement, postoperative nausea-vomiting, sedation and complications related to local anaesthetic and TQLB procedure. RESULTS: The mean [standard deviation (SD)] time to first analgesic request was 7.8 (1.5) hours in Group-Q and 3.2 (1.0) hours in Group-C (P < 0.0001). The mean (SD) dose of fentanyl used in 24 hours was 167.3 (44) μg in Group-Q and 226.5 (41.9) μg in Group-C (P < 0.0001). CONCLUSION: The ultrasound-guided TQLB provides effective postoperative analgesia after TLH surgery in a multimodal analgesia approach. It reduces the fentanyl consumption and improves the visual analogue scale (VAS) score. Wolters Kluwer - Medknow 2021-05 2021-05-20 /pmc/articles/PMC8202790/ /pubmed/34211193 http://dx.doi.org/10.4103/ija.IJA_1258_20 Text en Copyright: © 2021 Indian Journal of Anaesthesia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Jadon, Ashok Ahmad, Asif Sahoo, Rajendra K Sinha, Neelam Chakraborty, Swastika Bakshi, Apoorva Efficacy of transmuscular quadratus lumborum block in the multimodal regimen for postoperative analgesia after total laparoscopic hysterectomy: A prospective randomised double-blinded study |
title | Efficacy of transmuscular quadratus lumborum block in the multimodal regimen for postoperative analgesia after total laparoscopic hysterectomy: A prospective randomised double-blinded study |
title_full | Efficacy of transmuscular quadratus lumborum block in the multimodal regimen for postoperative analgesia after total laparoscopic hysterectomy: A prospective randomised double-blinded study |
title_fullStr | Efficacy of transmuscular quadratus lumborum block in the multimodal regimen for postoperative analgesia after total laparoscopic hysterectomy: A prospective randomised double-blinded study |
title_full_unstemmed | Efficacy of transmuscular quadratus lumborum block in the multimodal regimen for postoperative analgesia after total laparoscopic hysterectomy: A prospective randomised double-blinded study |
title_short | Efficacy of transmuscular quadratus lumborum block in the multimodal regimen for postoperative analgesia after total laparoscopic hysterectomy: A prospective randomised double-blinded study |
title_sort | efficacy of transmuscular quadratus lumborum block in the multimodal regimen for postoperative analgesia after total laparoscopic hysterectomy: a prospective randomised double-blinded study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202790/ https://www.ncbi.nlm.nih.gov/pubmed/34211193 http://dx.doi.org/10.4103/ija.IJA_1258_20 |
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