TQL-block for Laparoscopic Hemicolectomy

• Status: Completed
• Trial end date: 2021-01-03
• Target enrollment: 0
• Participant gender: All

Summary

Every year 350 patients undergo surgery due to colorectal cancer at Zealand University Hospital, Roskilde. The majority of the surgeries are performed using a minimal invasive laparoscopic technique where the bowl anastomosis is either hand sown or stapled. The procedure is performed, while the patient is under general anaesthesia.

An observational prospective survey from 2016-17 of sixty patients undergoing hemicolectomy at Zealand University Hospital, Roskilde has shown, that even though the patients are subjected to a multimodal analgesic regimen, a substantial amount of opioids are being administered during the first 24 hours post surgery; i.e. 51.91 mg ± 36.22 mg (Mean ± SD) of oral morphine equivalents. Sixty-five percent of the patients receive opioids at the PACU. Their maximum pain score at the PACU is registered, using a numerical rating scale of 0-10, as 3.28 ± 2.65 (Mean ± SD). So it is obvious that there is room for improvement and a reduction in the use of postoperative opioids. Thus, there is a clearly defined research problem to explore.

Currently ultrasound-guided nerveblocks are not part of the multimodal analgesic regimen.

The primary aim of this study is to investigate the efficacy of the ultrasound-guided bilateral transmuscular quadratus lumborum block on reducing postoperative opioid consumption.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Zealand University Hospital
• Treatments: Acetaminophen; Morphine; Ropivacaine

Criteria

Inclusion Criteria:

• Age > 18

• Scheduled for laparoscopic or robot assisted hemicolectomy or sigmoidectomy due to colon cancer

• Have received thorough information, oral and written, and signed the "Informed Consent" form on participation in the trial

• American Society of Anaesthesiologist physical status classification, class 1-3

Exclusion Criteria:

• Inability to cooperate

• Inability to speak and understand Danish

• Allergy to local anaesthetics or opioids

• Daily intake of opioids (evaluated by the investigators)

• Drug and/or substance abuse

• Local infection at the site of injection or systemic infection

• Difficulty visualisation of muscular and fascial structures in ultrasound visualisation necessary to the block administration

• Pregnant* or breastfeeding

• Daily use of oral or intravenous steroids

• Known immune deficiency (evaluated by the investigators)

• Other simultaneous or previous cancer diagnosis (except non-melanoma skin cancer) within the last five years (within the last five years added 28th nov 2019 after ethics committee approval).