An observational study in Bladder Cancer, Postoperative Pain Management and Opioid Consumption, sponsored by Namik Kemal University. Completed at 1 site in Turkey. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2025-02-28.
Sponsored by Namik Kemal University · Observational
This retrospective observational study evaluates the effects of different Quadratus Lumborum Block (QLB) techniques on postoperative recovery and total opioid consumption in patients undergoing radical cystectomy under general anesthesia. The study will analyze intraoperative and postoperative patient records from October 15, 2023, to October 15, 2024, at Tekirdağ Namık Kemal University Hospital.
Patients who received anterior or posterior QLB for postoperative analgesia will be included. Data collection will involve demographic information, total opioid consumption (morphine milligram equivalents), recovery quality scores (QoR-15), postoperative pain scores (Visual Analog Scale, VAS), time to first rescue analgesic administration, frequency of rescue analgesic use, and incidence of postoperative nausea and vomiting (PONV).
The retrospective analysis will compare the two QLB techniques to determine if there is a significant difference in postoperative opioid consumption and recovery quality. Statistical methods will be used to assess pain scores over time, opioid consumption, and overall recovery quality.
Postoperative pain management plays a crucial role in optimizing recovery after radical cystectomy, as inadequate pain control can lead to increased opioid consumption and delayed rehabilitation. This retrospective observational study examines the effects of two different Quadratus Lumborum Block (QLB) techniques-anterior and posterior approaches-on postoperative pain and opioid consumption.
The study includes patients who underwent radical cystectomy under general anesthesia at Tekirdağ Namık Kemal University Hospital between October 15, 2023, and October 15, 2024. The primary focus is to compare total opioid consumption (morphine milligram equivalents) within the first 24 hours after surgery between the two groups.
Secondary outcomes include:
Data will be collected from intraoperative and postoperative patient records. Statistical analysis will compare anterior vs. posterior QLB techniques, evaluating differences in postoperative opioid consumption, pain relief efficacy, and recovery quality (QoR-15 scores).
This study aims to provide evidence-based insights into the use of regional anesthesia techniques for radical cystectomy patients, supporting the refinement of multimodal analgesia strategies to optimize pain management and minimize opioid exposure.
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This study includes adult patients (18-65 years old) who underwent radical cystectomy under general anesthesia at Tekirdağ Namık Kemal University Hospital between October 15, 2023, and October 15, 2024. Patients were retrospectively selected based on the administration of anterior or posterior Quadratus Lumborum Block (QLB) for postoperative analgesia. Patients with complete medical records were included, while those with missing data, coagulopathy, chronic opioid use, or unplanned open surgery conversion were excluded.
Exclusion Criteria:
Patients who underwent radical cystectomy under general anesthesia and received anterior quadratus lumborum block (QLB) for postoperative analgesia.
Procedure: Anterior Quadratus Lumborum Block (QLB)
Patients who underwent radical cystectomy under general anesthesia and received posterior quadratus lumborum block (QLB) for postoperative analgesia.
Procedure: Posterior Quadratus Lumborum Block (QLB)
A regional anesthesia technique where local anesthetic is injected anterior to the quadratus lumborum muscle under ultrasound guidance for postoperative pain management.
A regional anesthesia technique where local anesthetic is injected posterior to the quadratus lumborum muscle under ultrasound guidance for postoperative pain management.
Total Opioid Consumption (Morphine Milligram Equivalents) in the First 24 Hours
The total amount of opioids (converted to morphine milligram equivalents) administered postoperatively within the first 24 hours following radical cystectomy. Continuous variable (mg of morphine equivalent)
Time frame: 0-24 hours postoperatively
Pain Scores Using Visual Analog Scale (VAS) at Multiple Time Points
Postoperative pain levels measured using the Visual Analog Scale (VAS) at predetermined time points: 0, 2, 6, 12, and 24 hours. Ordinal variable (0-10 VAS score, higher scores indicate more pain)
Time frame: 0, 2, 6, 12, and 24 hours postoperatively
Postoperative Recovery Quality (QoR-15 Score)
Recovery quality assessed using the QoR-15 questionnaire, a validated patient-reported outcome measure. Continuous variable (QoR-15 total score, higher scores indicate better recovery quality)
Time frame: 24 hours postoperatively
Time to First Rescue Analgesic Administration
The duration (in minutes) from the end of surgery until the first administration of rescue analgesia. Continuous variable (minutes)
Time frame: 0-24 hours postoperatively
Frequency of Rescue Analgesic Use
The number of times rescue analgesics were administered during the first 24 hours postoperatively. Count variable (number of doses)
Time frame: 0-24 hours postoperatively
Incidence of Postoperative Nausea and Vomiting (PONV)
The proportion of patients who experience postoperative nausea and vomiting within the first 24 hours. Binary variable (Yes/No; presence of PONV)
Time frame: 0-24 hours postoperatively
Plan to share: No
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Namik Kemal University