Quadratus Lumborum Block Using Loss-of-resistance Versus Ultrasound-guided Technique

Not Applicable

• Conditions: Quadratus Lumborum Block; Lower Abdominal Surgery
• Interventions: Procedure: Ultrasound-guided Quadratus lumborum block; Procedure: Loss-of-resistance Quadratus lumborum block; Procedure: General anesthesia

• Registration Number: NCT03328481
• Lead Sponsor: Cairo University

Brief Summary

This study aims to explore the feasibility of using loss-of-resistance technique for Quadratus Lumborum block (QLB). And to compare between the Ultrasound guided QLB type II and the loss-of-resistance technique for QLB as regards the degree and duration of analgesia and side effects.

Detailed Description

Quadratus lumborum block (QLB) is an abdominal plane block with increasing popularity. QLB is achieved by local anesthetic infiltration at the anterolateral aspect of quadratus lumborum muscle (QLB-I), or at the posterior aspect of the muscle (QLB-II), or transmuscular (QL-TM block). Ultrasound-guided technique is the usual route used for QLB performance. QLB had been considered a modification of transversus abdominis plane (TAP) block\[4\]. A cadaveric study had showed similar local anesthetic spread in both QL and TAP blocks.

TAP block could be performed by using either the ultrasound or loss-of-resistance technique; whilst, QLB is only performed using the ultrasound and the feasibility of loss-of-resistance technique had not been investigated for this block.

This study aims to explore the feasibility of using loss-of-resistance technique for QLB. And to compare between the Ultrasound guided QLB type II and the loss-of-resistance technique for QLB as regards the degree and duration of analgesia and side effects.

Study Timeline

• Study First Submitted: 2017-10-29
• Study First Submitted QC: 2017-10-29
• Study First Posted: 2017-11-01
• Study Start: 2018-05-28
• Status Verified: 2018-07
• Last Update Submitted: 2018-07-07
• Last Update Posted: 2018-07-10
• Primary Completion: 2018-09-15
• Study Completion: 2018-09-20

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 16

Inclusion Criteria

• Patients scheduled for lower abdominal surgery under general anesthesia

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Exclusion Criteria

• Patient refusal to regional block,
• Pregnancy
• Coagulopathy
• Cognitive impairment
• Inflammation or infection at the puncture site
• History of allergic reaction to study medications

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Loss-of-resistance	General anesthesia	Patients in this group will receive Loss-of-resistance Quadratus lumborum block with 30 ml bupivacaine 0.25% in addition to general anesthesia.
Ultrasound-guided	Ultrasound-guided Quadratus lumborum block	Patients in this group will receive Ultrasound-guided Quadratus lumborum block type-II with 30 ml bupivacaine 0.25% in addition to general anesthesia.
Loss-of-resistance	Loss-of-resistance Quadratus lumborum block	Patients in this group will receive Loss-of-resistance Quadratus lumborum block with 30 ml bupivacaine 0.25% in addition to general anesthesia.
Ultrasound-guided	General anesthesia	Patients in this group will receive Ultrasound-guided Quadratus lumborum block type-II with 30 ml bupivacaine 0.25% in addition to general anesthesia.

Primary Outcome Measures

Name	Time	Method
Duration of analgesia	24 hours	The time between the end of the surgery and the first analgesia request

Secondary Outcome Measures

Name	Time	Method
Postoperative morphine consumption	24 hours	The total amount of morphine needed during the first 24 hours
Intraoperative extra-analgesia requirements	3 hours	The total amount of analgesic drug boluses
visual analogue pain score at rest to assess the pain severity	24 hours	the grade of pain experienced by the patient at rest graded from 0 to 10. The lower the value, the better the score
Visual analogue pain score at movement to assess the pain severity	24 hours	the grade of pain experienced by the patient at movement graded from 0 to 10. The lower the value, the better the score
Systolic blood pressure	24 hours	the systolic blood pressure measured in mmHg
Heart rate	24 hours	The number of heart beats per minute

Trial Locations

Locations (1)

Cairo University; 🇪🇬 Cairo, Egypt