Symptoms and General Pathology

All Conditions

Neoplasms

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Nervous System Diseases

Pain, Postoperative

Prostatic Neoplasms

Pain

Postoperative Complications

Neurologic Manifestations

Genital Neoplasms, Male

Urogenital Neoplasms

Genital Diseases

Genital Diseases, Male

Urogenital Diseases

Prostatic Diseases

Male Urogenital Diseases

Central Nervous System Depressants

All Drugs and Chemicals

Bupivacaine

Anesthetics

Anesthetics, Local

Quadratus Lumborum block group (QL) patients will receive a bilateral Quadratus Lumborum block using Bupivicaine 0.125%

Transversus abdominis plane block (TAP) patients will receive a bilateral TAP block using Bupivicaine 0.125%

0.2 ml/kg bupivicaine 0.125% injected bilateraly at the posterior border of the quadratus Lumborum muscle

Quadratus Lumborum block

0.2 ml/kg bupivicaine 0.125% injected bilateraly between internal oblique and transversus abdominis muscles.

Tranversus Abdominis plane block

Tomasz Skladzien, MD PHD

Recently, the uses of peripheral axial blocks that deliver local anesthetic into the transversus abdominis fascial plane have become popular for operations that involve incision(s) of the abdominal wall. Thus, the Transversus Abdominis plane (TAP) block has been shown to reduce perioperative opioid use in elective abdominal surgery, including open appendicectomy, laparotomy, and laparoscopic cholecystectomy.

Currently, the Quadratus Lumborum block (QL block) is performed as one of the perioperative pain management procedures for all generations (pediatrics, pregnant, and adult) undergoing abdominal surgery. The local anesthetic injected via the approach of the posterior QL block ( QL 2 block ) can more easily extend beyond the TAP to the thoracic paravertebral space or the thoracolumbar plane, the posterior QL block entails a broader sensory-level analgesic and may generate analgesia from T7 to L1. Use of posterior QL block in laparoscopic prostatectomy has not been investigated before and it is the variant that will be discussed in our study.

In laparoscopic prostatectomy, overall pain is a conglomerate of three different and clinically separate components: incisional pain (somatic pain), visceral pain (deep intra abdominal pain), and shoulder pain due to peritoneal stretching and diaphragmatic irritation associated with carbon dioxide insufflation. Moreover, it has been hypothesized that intense acute pain after laparoscopic prostatectomy may predict development of chronic pain. Without effective treatment, this ongoing pain may delay recovery, mandate inpatient admission, and thereby increase the cost of such care.

Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)

Quadratus Lumborum Block vs Transversus Abdominis Plane Block for Post-prostatectomy Analgesia

Total cumulative oxycodone dose in mg used in the first 24 hours after surgery

VAS range from 0 for no pain to 10 for worst pain imaginable

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Quadratus Lumborum Block vs Transversus Abdominis Plane Block for Post-prostatectomy Analgesia	NCT03606889	Prostatic Cance... Pain, Postopera... Pain Anesthetics, Lo...	Quadratus Lumbo... Tranversus Abdo... Bupivacaine	18 Years - 90 Years	Jagiellonian University
Quadratus Lumborum Block vs Transversus Abdominis Plane Block for Post-prostatectomy Analgesia	NCT03606889	Prostatic Cance... Pain, Postopera... Pain Anesthetics, Lo...	Quadratus Lumbo... Tranversus Abdo... Bupivacaine	18 Years - 90 Years	Jagiellonian University

Spots Global Cancer Trial Database for tranversus abdominis plane block