Effectiveness of Transversus Abdominis Plane Block Versus Quadratus Lumborum Technique in Patients After Cesarean Section
Overview
- Phase
- Phase 4
- Intervention
- TAP (transversus abdominis plane block)
- Conditions
- Cesarean Section
- Sponsor
- Michał Borys
- Enrollment
- 232
- Locations
- 1
- Primary Endpoint
- Postoperative pain measured with VAS
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
Comparison of two types of analgesia after cesarean section.
All patients will anaesthetised with spinal technique. Ultrasound-guided transversus abdominis plane or quadratus lumborum block to treat postoperative pain. Postoperative pain will measured with visual-analogue scale (VAS). 1, 2, 6 months after surgery each patient will be called to assess neuropathic pain with Neuropathic Pain Symptom Inventory (NPSI).
Detailed Description
Written consent will be obtained before the cesarean section. Only subarachnoidally anaesthetised patients may participate in the study. Pencil-point spinal needle and bupivacaine (Marcaine Heavy Spinal 0.5 %) will be used. At the end of surgery ultrasound-guided regional block will be performed. Each patient will be randomly allocated to one of the treated group: transversus abdominis plane block (TAP) or quadratus lumborum (QL). Patients receive 0.2 mL of local anesthetic solution (0.25 % bupivacaine) on each side. Postoperative pain will be measured with VAS (visual-analogue scale) 2, 4, 8, 12 and 24 hours after the end of operation. Paracetamol, metamizol, ketoprofen may be given as required. Whenever pain exceeds 40 (VAS) 5 mg of morphine will be given intravenously (maximum two dosages per day). 1, 3, 6 months patients will be called to assess neuropathic pain. Neuropathic Pain Symptom Inventory (NPSI) will be used.
Investigators
Michał Borys
associate professor
Medical University of Lublin
Eligibility Criteria
Inclusion Criteria
- •obtained consent
- •singleton pregnancy
- •subarachnoid anaesthesia
Exclusion Criteria
- •coagulopathy
- •allergy to to local anesthetics
- •depression, antidepressant drugs treatment
- •usage of painkiller before surgery
- •addiction to alcohol or recreational drugs
Arms & Interventions
TAP (transversus abdominis plane)
Ultrasound-guided transversus abdominis plane block at the end of cesarean section
Intervention: TAP (transversus abdominis plane block)
TAP (transversus abdominis plane)
Ultrasound-guided transversus abdominis plane block at the end of cesarean section
Intervention: Needle
TAP (transversus abdominis plane)
Ultrasound-guided transversus abdominis plane block at the end of cesarean section
Intervention: Bupivacaine
TAP (transversus abdominis plane)
Ultrasound-guided transversus abdominis plane block at the end of cesarean section
Intervention: Paracetamol
TAP (transversus abdominis plane)
Ultrasound-guided transversus abdominis plane block at the end of cesarean section
Intervention: Metamizol
TAP (transversus abdominis plane)
Ultrasound-guided transversus abdominis plane block at the end of cesarean section
Intervention: Ketoprofen
TAP (transversus abdominis plane)
Ultrasound-guided transversus abdominis plane block at the end of cesarean section
Intervention: Morphine
QL (quadratus lumborum)
Ultrasound-guided quadratus lumborum block at the end of cesarean section
Intervention: QL (quadratus lumborum block)
QL (quadratus lumborum)
Ultrasound-guided quadratus lumborum block at the end of cesarean section
Intervention: Bupivacaine
QL (quadratus lumborum)
Ultrasound-guided quadratus lumborum block at the end of cesarean section
Intervention: Needle
QL (quadratus lumborum)
Ultrasound-guided quadratus lumborum block at the end of cesarean section
Intervention: Paracetamol
QL (quadratus lumborum)
Ultrasound-guided quadratus lumborum block at the end of cesarean section
Intervention: Metamizol
QL (quadratus lumborum)
Ultrasound-guided quadratus lumborum block at the end of cesarean section
Intervention: Ketoprofen
QL (quadratus lumborum)
Ultrasound-guided quadratus lumborum block at the end of cesarean section
Intervention: Morphine
Outcomes
Primary Outcomes
Postoperative pain measured with VAS
Time Frame: up to 24 hours after surgery
Acute pain measured with VAS (visual-analogue scale).
Secondary Outcomes
- Neuropathic pain assessed with NPSI(6 months from the surgery)