The effect of dexamethasone as an adjuvant in quadratus lumborum block to improves analgesia after laparoscopic cholecystectomy: Controlled randomized study

Abstract

ABSTRACT Background The pain following a laparoscopic cholecystectomy is multifaceted; Therefore, it can be controlled by multimodal methods such as Transmuscular Quadratus Lumborum Block (TQLB) and analgesics. Objectives Determine the effectiveness of TQLB using Bupivacaine or Bupivacaine-Dexamethasone in improving the quality of analgesia after laparoscopic cholecystectomy procedures. Methods Under general anesthesia, ninety patients, ranging in age from eighteen to sixty, were scheduled for elective laparoscopic cholecystectomy surgery. Three groups of patients (30 patients in each) were randomly assigned who underwent bilateral ultrasound guided TQLB injected with 21 ml of the drug on each side. The Bupivacaine group (B) received (20 ml Bupivacaine hydrochloride 0.25% + 1 mL 0.9% normal saline); the Dexamethasone-Bupivacaine group (D) received (20 ml Bupivacaine hydrochloride 0.25% + 1 mL dexamethasone 4 mg); and the Control group (C) received (21 ml 0.9% normal saline). Results The initial analgesic request was significant longer in group D (18 h) more than B (14 h), and C (0.8 h). The total analgesic requirements were increased in group C. The visual Analogue Score at rest and movement always revealed no significant distinctions between groups B and D. However, all values were raised in the control group more than in the other groups. The percentage of patients who were satisfied with the technique was greater in groups B and D than in group C. Conclusions Ultrasound guided TQLB is a useful technique for raising patient satisfaction and analgesic quality. Furthermore, the addition of dexamethasone can prolong the duration of analgesia and decrease the postoperative Analgesia requirement.