Comaprison Between QLB and ESPB in Patients for PCNL Operation
Pain, Postoperative
About this trial
This is an interventional supportive care trial for Pain, Postoperative focused on measuring pain management, Nephrolithotomy, QLB, ESPB, Erector Spinae, Quadratus Lumborum, Anesthesia, ultrasound, regional anethesia
Eligibility Criteria
Inclusion Criteria:
- Both sex
- Age: 18-60
- ASA (American Society of Anesthesiologists) class I and II
- Elective surgery
- Patients undergoing PNL surgery
Exclusion Criteria:
- Patient's refusal
- Allergy or contraindications to drugs used in the study
- Emergency surgery
- Psychiatric disorders
- Severely co-morbid patients
- Inflammation or infection over injection site
- Bleeding diathesis; INR more than 1.5 and Platelet count less than 100,000/mm3
- Peripheral neuropathy
- Obese patients BMI ≥35
- Patients on previous opioid therapy
- Pre-operative haemoglobin <10 mg/dl
- Inability to properly describe postoperative pain to investigators
- Coagulation abnormalities
- History of drug addiction or alcohol abuse
- History of Previous renal surgery
Sites / Locations
- Assiut University Hospitals
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
QLB
ESPB
The patient is in the prone position, an ultrasound probe is placed in a transverse, oblique, and paramedian orientation approximately lateral to the posterior axillary line. The needle is then inserted in-plane from the medial side of the transducer and advanced laterally to enter the interfascial plane between the Quadratus Lumborum muscle and the kidney. We confirmed that the local anesthetic appeared to press down the kidney in the ultrasound image
Using aseptic technique, an ultrasound probe is placed at the T9 vertebral level. After identifying the ribs and sliding towards the midline in a longitudinal parasagittal orientation, the overlying Erector Spinae is identified by visualization of the transition between the rib and transverse apophysis a block needle is inserted in plane with ultrasound beam and is advanced in a cephalo-caudal direction until the tip contacted the transverse process.