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ULTRASOUND-GUIDED (USG) TRANSMUSCULAR QUADRATUS LUMBORUM BLOCK FOR UTERINE CANCER PATIENTS UNDERGOING TOTAL LAPAROSCOPIC HYSTERECTOMY (TLH). A DOUBLE BLIND, RANDOMISED, PLACEBO CONTROLLED TRIAL
Author(s): ,
Hansen, C.*
Affiliations:
Zealand University Hospital- University of Copenhagen, Department of Anaesthesiology and Intensive Care, Roskilde, Denmark
,
Dam, M.
Affiliations:
Zealand University Hospital- University of Copenhagen, Department of Anaesthesiology and Intensive Care, Roskilde, Denmark
,
Bennich, G.
Affiliations:
Zealand University Hospital- University of Copenhagen, Department of Gynaecology, Roskilde, Denmark
,
Bendtsen, T.
Affiliations:
Aarhus University Hospital- Denmark, Department of Anaesthesiology & Intensive Care Medicine, Aarhus, Denmark
Børglum, J.
Affiliations:
Zealand University Hospital- University of Copenhagen, Department of Anaesthesiology and Intensive Care, Roskilde, Denmark
ESRA Academy. Kruse Hansen C. Sep 13, 2017; 190965; 165 Topic: Peripheral Nerve Blocks
Disclosure(s): Nothing to disclose
Dr. Christian Kruse Hansen
Dr. Christian Kruse Hansen

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Abstract
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Background and Aims:

TLH is a very common gynaecological procedure. A one-year retrospective survey revealed a vast opioid consumption in this category of patients suffering from uterine cancer of approximately (mean±SD) 37.5±29.8 mg of oral morphine in the first 24 postoperative hours despite a multimodal analgesic regimen consisting of preoperatively administered oral Ibuprofen, Paracetamol, Dexamethasone, and subsequent intravenous Sufentanil 0.5-0.8 micrograms/kilo prior to emergence.

This study aims to evaluate the efficacy of bilateral TQL block in reducing postoperative morphine consumption and pain

Methods:

A single center, randomised, controlled and double-blinded trial with concealed allocation achieved ethics committee approval. Eighty-eight patients scheduled for TLH will be randomized to receive either bilateral USG TQL block with 60 ml Ropivacaine 0.375% or isotonic saline prior to surgery. Primary outcome: Accumulated opioid consumption during the first 24 postoperative hours. Secondary outcomes: NRS (0-10) pain scores at 6 and 12 hours, total morphine consumption, time to first opioid, adverse effects, satisfaction with treatment, time to ambulation. We will be able to detect a 50% reduction in recorded opioid consumption with α=5%, β=20% and a dropout rate of 15%

Results:

Preliminary results and study design from our ongoing randomised study will be presented

Conclusions:

The present study is powered to demonstrate whether bilateral USG TQL block can reduce postoperative opioid consumption and pain with clinical significance in patients undergoing TLH. Further studies will reveal whether this intervention also can reduce the development of chronic pain and if adjuvants or catheters could be a future regional anaesthesia strategy

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