Comparison of IL-6 and CRP Concentration Between Quadratus Lumborum and Epidural Blockade Among Living Kidney Donors: A Randomized Controlled Trial
| Autor: | Raden Besthadi Sukmono, Annemarie Chrysantia Melati, Pryambodho Pryambodho, Dita Aditianingsih, Aida Rosita Tantri, Rahendra Rahendra |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_treatment
Analgesic law.invention Sepsis 03 medical and health sciences 0302 clinical medicine Randomized controlled trial 030202 anesthesiology law C-reactive Protein Medicine Intubation 030212 general & internal medicine Bupivacaine biology Interleukin-6 business.industry Laparoscopic Nephrectomy C-reactive protein medicine.disease Catheter Anesthesiology and Pain Medicine Quadratus Lumborum Block Continuous Epidural Anesthesia Morphine biology.protein business Research Article medicine.drug |
| Zdroj: | Anesthesiology and Pain Medicine |
| ISSN: | 2228-7531 2228-7523 |
| DOI: | 10.5812/aapm.91527 |
| Popis: | Background An adequate anesthesia technique generates appropriate postoperative analgesic properties and decreases the patient's stress response. This will lead to decreased morbidity and mortality associated with immunology disturbances, such as infection, prolonged wound healing, and sepsis. Objectives The aim of this study was to compare interleukin-6 (IL-6) and C-reactive protein (CRP) concentrations, as the markers of the stress response, between continuous epidural and quadratus lumborum (QL) block as postoperative analgesia techniques among living kidney donors. Methods Sixty-two patients were randomly divided into two equal groups: continuous epidural and QL block. A group received bilateral QL block with 20 mL of bupivacaine 0.25% and the other received 6 mL/hour of bupivacaine 0.25% continuously via an epidural catheter. Prior to extubation, the QL block group received bilateral QL block with the same dose and the continuous epidural group was administered with 6 mL/hour of bupivacaine 0.125%. Blood samples were drawn to compare IL-6 and CRP concentrations after intubation (preoperatively), directly after surgery, 24 hours postoperatively, and 48 hours postoperatively. Postoperative pain was measured with the numerical rating scale (NRS). Morphine requirement and duration of catheter usage were also measured postoperatively. Side effects within 24 hours postoperatively were noted. Data were analyzed with independent t-test or Mann-Whitney test. Results No difference was observed between the groups in the plasma concentration of IL-6 either after surgery or 24 hours postoperatively (P = 0.785 and P = 0.361, respectively) although the mean IL-6 concentration 24 hours postoperatively was lower in the QL block group than in the continuous epidural group. CRP concentration was not significantly different between the groups either after surgery or 48 hours postoperatively (P = 0.805 and P = 0.636, respectively). Conclusions There was no significant difference in IL-6 and CRP concentrations between continuous epidural and QL block among living kidney donors. Both continuous epidural and QL block techniques showed comparable postoperative analgesic properties among living kidney donors undergoing laparoscopic nephrectomy. |
| Databáze: | OpenAIRE |
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