The effect of transmuscular quadratus lumborum block on postoperative opioid consumption in patients undergoing percutaneous nephrolithotomy: A randomized controlled study

Background This study aimed to investigate the effect of ultrasound-guided transmuscular quadratus lumborum block (QLB) on postoperative opioid consumption in patients undergoing percutaneous nephrolithotomy (PCNL). Methodology A total of 40 patients aged between 18 and 60 who were classified as American Society of Anesthesiologists status I-II and scheduled for unilateral PCNL were randomly divided into two groups. Patients in Group QLB (n = 20) received a single-shot QLB with 20 mL of 0.25% bupivacaine in the preoperative period. No intervention was performed in the control group (Group C, n = 20). Dermatomes affected by the block procedure were evaluated in the preoperative period in the group of patients who were administered the block procedure. General anesthesia was administered to all patients in both groups. In the postoperative period, opioid consumption, pain scores, side effects related to opioid consumption, and additional analgesic requirements were recorded. Results Opioid consumption was significantly lower in Group QLB compared to Group C at all times (p < 0.05). Postoperative visual analog scale (VAS) scores during the movement were significantly lower in Group QLB compared to Group C at all times (p < 0.05). VAS scores at rest were reported to be significantly lower in Group QLB compared to Group C, except for the eighth and twelfth hours (p < 0.05). The requirement for additional analgesic agents was significantly lower in Group QLB compared to Group C (p < 0.05). Conclusions QLB reduced postoperative opioid consumption and VAS scores by providing more effective analgesia compared to the control group in patients who underwent PCNL

The Effects of Positive End-Expiratory Pressure at Different Levels on Postoperative Respiration Parameters in Patients Undergoing Laparoscopic Cholecystectomy

Purpose/Aim of the study: We investigated the effects of different positive end-expiratory pressure (PEEP) levels on postoperative respiration parameters in patients undergoing laparoscopic cholecystectomy. Materials and Methods: One hundred and five consecutive patients were randomly divided to three groups (n = 35, for each group). Group I did not receive PEEP whereas group II received PEEP as 5 cmH2O and group III received PEEP as 8 cm H2O. Measurements with spirometer were taken 1 hour before the operation (T1) and, 1 (T2), 6 (T3), and 24 hours (T4) after extubation by an anesthetist. Forced expiratory volume (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF) were recorded. Results: Group I had higher FVC values measured at T2 time point compared with other groups (p < 0.05, for both groups). There was a statistically significant difference between group I and group III in terms of the FVC values measured at T3 and T4 time points (p = 0.05 and p < 0.05, retrospectively). A statistical difference was found between group I and group II in terms of FEV1 measured at T2 time point (p < 0.05). Group I had higher FEV1 values measured at T3 and T4 time points compared to group III (p = 0.05, P<0.05; respectively). Group III had lower PEF values measured at T4 time point compared to group I and II (p < 0.05). Conclusions: We concluded that PEEP with 5 or 8 cmH2O has negative effects on lung function tests measured with spirometer during postoperative 1st, 6th, and 24th hours in patients underwent elective laparoscopic cholecystectomy