Application of Ultrasound-guided Intercostal Nerve Block in Retroperitoneal Laparoscopic Nephrectomy

Purpose: Surgical stimulation causes many pathophysiological changes which are not conducive to the recovery of patients, this trail aims to investigate whether intercostal nerve block can reduce the perioperative stress response and postoperative pain in patients undergoing elective retroperitoneal laparoscopic nephrectomy.Patients and methods:40 patients were recruited and randomly assigned to Test groupand Blank group.Results: Our study found that the catecholamine and cortisol levels in two groups were higher than the baseline value after pneumoperitoneum, (P＜0.05), while the catecholamine level was lower in Test groupthan in Blank group (P＜0.05), and there is no differences of cortisol levels was observed in two groups. The catecholamines and cortisol levels of two groups were basically restored to the preoperative level after 24 hours surgery, The concentration of IL-6 and IL-10 in two groups increased at 24 hours after surgery, but there was no differences was observed between the two groups at the same point. And the usage of analgesic during operation was less in the Test group than Blank group (P＜0.05).Conclusion : Intercostal nerve block can reduce the stress response of patients undergoing retroperitoneal laparoscopic nephrectomy and reduce the usage of perioperative analgesics.Tial registration statement : This trial has been applied by the ethics Association of Chongqing cancer hospital.

Isolated large renal hydatid cyst treated by laparoscopic nephrectomy

Hydatid disease is caused by Echinococcus granulosus, which causes rare isolated presentation in the kidneys, and is estimated to be about 2-4% of all cases. We herein present a case of a 45-year-old symptomatic male patient with a large primary hydatid cyst in the left kidney that was treated successfully by laparoscopic left nephrectomy.

Comparison of ultrasound-guided anterior quadratus lumborum block at the lateral supra-arcuate ligament with posterior quadratus lumborum block for perioperative analgesia in laparoscopic nephrectomy: a protocol for a randomised, prospective, parallel group, non-inferior trial

ObjectiveAnterior quadratus lumborum block at the lateral supra-arcuate ligament (QLBA) is a new method for postoperative pain relief in patients undergoing abdominal surgery. Perioperative QLBA is effective, but it has not been compared with posterior quadratus lumborum block (QLB2). The present study aims to evaluate the postoperative pain of patients undergoing laparoscopic nephrectomy surgery with QLBA versus QLB2.Methods/designThis study is a randomised, prospective, parallel group, non-inferior trial. All patients undergoing laparoscopic nephrectomy surgery will be randomised 1:1 to the QLBA group or the QLB2 group with general anaesthesia. The objective of the trial is to evaluate the postoperative pain of patients undergoing laparoscopic nephrectomy surgery with QLBA (n=50) versus QLB2 (n=50). The primary outcome for this trial is the Visual Analogue Scale scores at rest and activity (dynamic pain scores are assessed with a cough or a trial to sit up in bed) 2 hours after surgery between patients who receive QLBA versus QLB2. The secondary objectives will be to compare (1) pain at rest and activity 0.5 hour, 2 hours, 24 hours, 48 hours after surgery; (2) the time spent on block operation; (3) the blocked dermatomal coverage 5 min and 15 min after block operation; (4) intraoperative opioid consumption; (5) types and doses of the rescue analgesic after surgery; (6) nausea and vomiting score within 24 hours after surgery; (7) time from the end of surgery to the first onset significant pain; (8) patient satisfaction score.DiscussionClinical experience has supported that QLB is a very effective postoperative analgesic method, and we will answer the following questions in this trial: Will both approaches have the same analgesic effect and duration? Will the QLBA have a non-inferior postoperative analgesic effect compared with QLB2 or the QLBA be able to prolong the duration of analgesia after surgery? The results of this study could have actual clinical applications that could help to reduce postoperative pain and shorten hospital stays.Ethics and disseminationThe study design was approved by the ethical committee of Beijing Chao-Yang Hospital, Beijing, China (2020-ke-321). The trial results will be published in peer-reviewed journals and at conferences.Trial registration numberChiCTR2000035354.