Effect of anterior quadratus lumborum block with ropivacaine on the immune response after laparoscopic surgery in colon cancer: a substudy of a randomized clinical trial
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Effect of anterior quadratus lumborum block with ropivacaine on the immune response after laparoscopic surgery in colon cancer : a substudy of a randomized clinical trial. / Balsevicius, Lukas; Urbano, Paulo C.M.; Hasselager, Rune Petring; Mohamud, Ahmed Abdirahman; Olausson, Maria; Svraka, Melina; Wahlstrøm, Kirsten L.; Oppermann, Carolin; Gögenur, Dilara Seyma; Hølmich, Emma Rosenkrantz; Cappelen, Britt; Sækmose, Susanne Gjørup; Tanggaard, Katrine; Litman, Thomas; Børglum, Jens; Brix, Susanne; Gögenur, Ismail.
In: Regional Anesthesia and Pain Medicine, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Effect of anterior quadratus lumborum block with ropivacaine on the immune response after laparoscopic surgery in colon cancer
T2 - a substudy of a randomized clinical trial
AU - Balsevicius, Lukas
AU - Urbano, Paulo C.M.
AU - Hasselager, Rune Petring
AU - Mohamud, Ahmed Abdirahman
AU - Olausson, Maria
AU - Svraka, Melina
AU - Wahlstrøm, Kirsten L.
AU - Oppermann, Carolin
AU - Gögenur, Dilara Seyma
AU - Hølmich, Emma Rosenkrantz
AU - Cappelen, Britt
AU - Sækmose, Susanne Gjørup
AU - Tanggaard, Katrine
AU - Litman, Thomas
AU - Børglum, Jens
AU - Brix, Susanne
AU - Gögenur, Ismail
N1 - Publisher Copyright: © American Society of Regional Anesthesia & Pain Medicine 2023. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2024
Y1 - 2024
N2 - Background: Surgery induces a temporal change in the immune system, which might be modified by regional anesthesia. Applying a bilateral preoperative anterior quadratus lumborum block has proven to be a safe and effective technique in pain management after abdominal and retroperitoneal surgery, but the effect on the immune response is not thoroughly investigated. Methods: This study is a substudy of a randomized, controlled, double-blinded trial of patients undergoing laparoscopic hemicolectomy due to colon cancer. Twenty-two patients were randomized to undergo either a bilateral anterior quadratus lumborum nerve block with a total of 60 mL ropivacaine 0.375% or placebo with corresponding isotonic saline injections. The main objective of this exploratory substudy was to investigate the systemic immune response in the first postoperative day by examining changes in blood transcript levels (n=750) and stimulated secretion of cytokines (n=17) on ex vivo activation with microbial ligands and anti-CD3/CD28. Results: Using unsupervised data analysis tools, we observed no effect of the bilateral anterior quadratus lumborum nerve block on gene expression in immune cells (permutational multivariate analysis of variance using distance matrices: F=0.52, p=0.96), abundances of major immune cell populations (Wilcoxon rank-sum test: p>0.05), and stimulated cytokine secretion (Wilcoxon rank-sum test: p>0.05). Conclusions: Our study provides evidence that administration of bilateral anterior quadratus lumborum nerve block as a part of a multimodal analgesic regimen in an enhanced recovery after surgery for laparoscopic hemicolectomy in this cohort does not alter the systemic immune response. Trial registration number NCT03570541.
AB - Background: Surgery induces a temporal change in the immune system, which might be modified by regional anesthesia. Applying a bilateral preoperative anterior quadratus lumborum block has proven to be a safe and effective technique in pain management after abdominal and retroperitoneal surgery, but the effect on the immune response is not thoroughly investigated. Methods: This study is a substudy of a randomized, controlled, double-blinded trial of patients undergoing laparoscopic hemicolectomy due to colon cancer. Twenty-two patients were randomized to undergo either a bilateral anterior quadratus lumborum nerve block with a total of 60 mL ropivacaine 0.375% or placebo with corresponding isotonic saline injections. The main objective of this exploratory substudy was to investigate the systemic immune response in the first postoperative day by examining changes in blood transcript levels (n=750) and stimulated secretion of cytokines (n=17) on ex vivo activation with microbial ligands and anti-CD3/CD28. Results: Using unsupervised data analysis tools, we observed no effect of the bilateral anterior quadratus lumborum nerve block on gene expression in immune cells (permutational multivariate analysis of variance using distance matrices: F=0.52, p=0.96), abundances of major immune cell populations (Wilcoxon rank-sum test: p>0.05), and stimulated cytokine secretion (Wilcoxon rank-sum test: p>0.05). Conclusions: Our study provides evidence that administration of bilateral anterior quadratus lumborum nerve block as a part of a multimodal analgesic regimen in an enhanced recovery after surgery for laparoscopic hemicolectomy in this cohort does not alter the systemic immune response. Trial registration number NCT03570541.
KW - Anesthesia, Local
KW - Injections, Spinal
KW - Nerve Block
UR - http://www.scopus.com/inward/record.url?scp=85178041571&partnerID=8YFLogxK
U2 - 10.1136/rapm-2023-104896
DO - 10.1136/rapm-2023-104896
M3 - Journal article
C2 - 37945063
AN - SCOPUS:85178041571
JO - Regional Anesthesia and Pain Medicine
JF - Regional Anesthesia and Pain Medicine
SN - 1098-7339
M1 - 104896
ER -
ID: 377837906