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Application of ultrasound-guided paraspinal block combined with lumbar quadratus block in laparoscopic radical resection of colorectal cancer

ABSTRACT: Interventions: Experimental group:Ultrasound-guided paravertebral nerve block combined with lumbar quadratus muscle block;Control group:Bilateral lumbar quadratus block guided by ultrasound Primary outcome(s): VAS score at rest and exercise at 2, 4, 6, 12, 24 and 48 hours after operation Study Design: Parallel

DISEASE(S): Colorectal Cancer

PROVIDER: 2701065 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Intervention1: Continuous Bilateral Quadratus Lumborum Block: Patients in CQL (II) group will undergo ultrasound-guided QL (II) block as described by Quiang Zhu et al. The patient should be placed in the left lateral position and a roll to be placed in between the rib cage and transverse process of the left side to open up the opposite space. (22) Then a low frequency convex probe (SonoSite edge transducer, 25 MHz) will be placed at the L2 transverse level near posterior axillary line of the right side to locate the sham-rock sign. The thoracolumbar fascia between the quadratus lumborum and psoas major is identified by optimising the gain. A 19G nerve block needle will be used (PlexoLong Nanoline continuous nerve block Kit, PAJUNK Inc.) to insert by in-plane method from the dorsal to ventral direction. After reaching the front edge of the quadratus lumborum, hydrodissection with 5 ml of normal saline will be done to separate the muscle and the fascia which will indicate that the needle tip has reached the appropriate position. Ropivacaine 0.2% at 0.3 mlÂ·kg 1 will be injected after negative aspiration and then, a 20 G catheter will be placed through the sheath tube at a depth of approximately 5 cm. A subcutaneous tunnel of 3 cm will be made to prevent catheter dislodgment. The same procedure will be followed in the right side. Control Intervention1: Continuous Epidural Block: Patients in the EPI group will undergo epidural placement (in between T9 and T11 level in patients undergoing left-sided hemicolectomy and anorectal surgery and between T8 and T10 in patients undergoing right-sided hemicolectomy) as per the institutional protocol. Patients with block height above T7 level 30 min after completion of the block (in both groups) will be included in the stu Primary outcome(s): 1.To compare NRS scores (at rest) between the continuous quadratus lumborum (CQLâ?¡) and Epidural (Ep) groups at 24 hours after surgery.Timepoint: 1.To compare NRS scores (at rest) between the continuous quadratus lumborum (CQLâ?¡) and Epidural (Ep) groups at 24 hours after surgery. Study Design: Randomized, Parallel Group Trial Method of generating randomization sequence:Computer generated randomization Method of allocation concealment:On-site computer system Blinding and masking:Outcome Assessor Blinded

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Application of ultrasound-guided paraspinal block combined with lumbar quadratus block in laparoscopic radical resection of colorectal cancer

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