الفهرس 
Introduction and Aim of the workOnly 14 pages are availabe for public view
 |  | from | 128 |  |  |
| | | from | 128 | | |
Abstract
This prospective randomized double blinded controlled study was carried out at El-Minia University Hospital during the period from March 2018 to December 2018. A total of 90 patients of either sex, age between 18-60 years, American society of anesthesiologists class I or II were scheduled for elective laparoscopic cholecystectomy surgery under general anesthesia.
The aim of the present study was to compare the effectiveness of transmuscular Quadratus Lumborum block using Bupivacaine versus Bupivacaine- Dexamethasone in providing analgesia in patients undergoing laparoscopic cholecystectomy.
The patients were randomly allocated into three groups each contains (30) patient. Control group (C) received bilateral ultrasound guided quadratus lumborum block using (20 ml 0.9% normal saline + 1mL 0.9% normal saline) in each side ,Bupivacaine group (B) received bilateral quadratus lumborum block using (20 ml Bupivacaine hydrochloride 0.25% + 1mL 0.9% normal saline) in each side and Dexamethasone-Bupivacaine group (D) received bilateral quadratus lumborum block using (20 ml Bupivacaine hydrochloride 0.25% + 1 mL dexamethasone “4mg”) in each side.
The following Variables : heart Rate, mean arterial Blood Pressure, peripheral oxygen saturation, visual analogue pain scale , time to first analgesic request, total Analgesic requirement, patient satisfaction and complications were Recorded and compared between groups
Regarding heart rate and mean arterial blood pressure were increased significantly in the control group (C) more than other two groups (B and D) while there was no statistical difference between group D and B ,all groups were comparable regarding peripheral oxygen saturation.
Regarding visual analogue pain score at rest and movement (sitting position) during comparing the three groups, there were no statistically significant differences between the two groups (B and D ) at all-time intervals . But all values were raised in the control group more than the other groups.
The time of first analgesic request was longer in D(18h) and B (14h) groups than C group(0.8h) and subsequently the total analgesic requirements were increased in C group more than the other two groups.
Percentage of patients who satisfied from the technique were higher in the groups B and D more than the C group.
Incidence of postoperative nausea and vomiting was higher significantly in group C than groups D and B .
Regarding bradycardia and itching there were insignificant difference between groups.
We concluded that ultra sound guided Quadratus lumborum block is an effective technique for reducing post-operative pain after laparoscopic cholecystectomy as it provides reduction in pain score ,delaying in time of first analgesic request and less analgesic requirement .
The addition of Dexamethasone to Bupivacaine in ultra sound guided Quadratus Lumborum block produces longer post-operative analgesia resulting in lesser requirements for rescue analgesia without side effects.