Analgesic effect of ultrasound guided regional block in laparoscopic cholecystectomy | ||||
| Minia Journal of Medical Research | ||||
| Volume 31, Issue 2, April 2020, Page 150-161 PDF (480.7 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjmr.2022.220854 | ||||
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| Authors | ||||
| Ahmed H. Mohamed; Shadwa R. Mohamed; Mohamed . A Farouk | ||||
| Department of Anesthesia, El-Minia Faculty of Medicine | ||||
| Abstract | ||||
| Introduction: Laparoscopic cholecystectomy (LC) is a proven, gold standard surgical procedure for management of gallbladder stones. Early and easily recovery, less operative morbidities, less postoperative pain, earlier return of bowel function, improved cosmetics, an earlier return to full activity, less hospitalization day and decreased overall cost are the superiorities of laparoscopic cholecystectomies comparing with open surgical procedures (Rubert et al., 2016). Aim of the work: Comparison of the efficacy and advantages of Erector Spinae block versus Quadratus Lumborum block on post-operative pain in laparoscopic cholecystectomy operations. Patients and methods: After ethical committee approval and written informed consent were obtained from all patients, this prospective randomized double blind controlled study was carried out at El-Minia University Hospital during the period from April 2019 to December 2019 on 60 adult patients of both sex, their age ranged from 18-70 years of American society of anesthesiologists (ASA) physical status I and II scheduled for elective laparoscopic cholecystectomy under general anesthesia. The patients were randomly allocated into three parallel equal groups of 20 patients in each group by using computer generated table. Group Q "Quadratus lumborum block": Received bilateral ultra sound guided Quadratus Lumborum block using 20 ml Bupivacaine0.25% (on each side). Group E "Erector spinae block": Received bilateral ultra sound guided erector spinae block using 20 ml Bupivacaine0.25% (on each side). Group C "Control group": Didn't receive any of previous blocks neither Quadratus Lumborum nor Erector Spinae blocks. All groups undergo the same anesthetic technique. The following variables (SBP, DBP, MAP, HR, SpO2) were recorded just before induction, after block, intraoperative and at 5,10,20,30,40,50,60 min. after the block then every 15 min. until the end of the operation. Total intra operative fentanyl requirement, total number of patients needed fentanyl, Postoperative: Recovery score, HR, MAP and SaO2 at 1, 2, 4, 6, 8, 12, 16, 20, 24 hour post-operative, VAS at 1, 2, 4, 6, 8, 12, 16, 20, 24 hour post-operative, time of The first analgesic request.Total analgesic requirement of fentanyl.Incidence of any side effect and time of discharge from recovery room. Complications: injury to the underlying structures, hematoma formation as recorded under ultrasound guidance, post- operative nausea and vomiting., pruritis, urinary retention, Bradycardia and hypotension and respiratory depression. Results: Hemodynamic and VAS were the least in group E followed by group Q while it was the highest in group C. Conclusion: Ultrasound guided Erector spinae block before laparoscopic cholecystectomy operation was effective in fulfill analgesia postoperative and decrease intra and postoperative hemodynamics, VAS score postoperative and facilitate ambulance postoperative when compared to group Quadratus Lumborum and control group. | ||||
| Keywords | ||||
| Pain; analgesia; laparoscopic cholecystectomy; ultrasound guided Erector Spinae block; ultrasound guided Quadratus Lumborum block; VAS score at rest and at cough; bupivacaine 0.25% | ||||
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