Comparison of Two Techniques of Quadratus Lumborum Block

Not Applicable

• Conditions: Nerve Block
• Interventions: Procedure: transverse scan, in-plane, posterior- anterior quadratus lumborum block; Procedure: paramedian sagittal longitudinal scan, in-plane, caudal-cranial quadratus lumborum block

• Registration Number: NCT05001802
• Lead Sponsor: Peking Union Medical College Hospital

Brief Summary

Our objective is to investigate the extent of cranial dermatomal spread of transmuscular quadratus lumborum block(TMQLB )when equal dosage(ml/kg) of local anesthetic are injected with the transverse versus an modified paramedian sagittal approach for patients undergoing laparoscopic adrenalectomy.

Detailed Description

The paramedian sagittal oblique transmuscular quadratus lumborum block(TMQLB )approach has been introduced to facilitate cranial spread by injecting the local in a caudal to cranial direction compared with the transverse approach. Currently, there are no data comparing the two techniques mentioned above with regards to extent of spread level. Our objective is to investigate the extent of cranial dermatomal spread of TMQLB when equal dosage(ml/kg) of local anesthetic are injected with the transverse versus an modified paramedian sagittal approach for patients undergoing laparoscopic adrenalectomy. In addition, the investigators wish to compare the performance time, caudal dermatomal spread of TMQLB and postoperative analgesia effect.

Study Timeline

• Study First Submitted: 2021-05-19
• Study First Submitted QC: 2021-08-03
• Study First Posted: 2021-08-12
• Study Start: 2021-08-20
• Status Verified: 2021-11
• Last Update Submitted: 2021-11-15
• Primary Completion: 2021-11-16
• Last Update Posted: 2021-11-17
• Study Completion: 2021-12-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

• ≥Age 18yrs

  • American Society of Anesthesiologists physical status I-II
  • Undergo laparoscopic adrenalectomy
  • Informed consent
  • Able to cooperate with study process

Exclusion Criteria

• Allergy to local anesthetic and other medications used in the study
• Patient refusal or lack of informed consent
• Coexisting hematological disorder or with deranged coagulation parameters
• Pre-existing major organ dysfunction such as hepatic and renal failure
• History of previous renal surgery.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
transverse quadratus lumborum block	transverse scan, in-plane, posterior- anterior quadratus lumborum block	The patients will receive the transmuscular quadratus lumborum block before surgery using the transverse scan, in-plain, posterior to anterior approach. 0.6ml/kg 0.375% ropivacaine is injected when the correct needle location is confirmed.
longitudinal quadratus lumborum block	paramedian sagittal longitudinal scan, in-plane, caudal-cranial quadratus lumborum block	The patients will receive the transmuscular quadratus lumborum block before surgery using the paramedic sagittal longitudinal scan, in-plain, caudal-cephalic approach.0.6ml/kg 0.375% ropivacaine is injected when the correct needle location is confirmed.

Primary Outcome Measures

Name	Time	Method
Cephalic sensory dermatomal spread	20 minutes after block performance]	The pinprick method at the midclavicular line was used to assess the extent of the dermatomal blockade, 20 minutes following the completion of the procedure by a person who was blinded to group allocation. The most cephalic dermatomal level that show a decreased pinprick sensation is recorded.A block failure was defined as the absence of any demonstrable sensory block 20 minutes after performance of the block.

Secondary Outcome Measures

Name	Time	Method
Incidence of complication	Within 48 hours after surgery	incidence of complication including bleeding, hematoma, infection at puncture site, local anesthetic poisoning, etc
rescue analgesics usage	At 0,12,24,48 hours after surgery	NSAIDs or opioids used for pain relief and their dosage
Time to performance of procedure	Duration of procedure	Duration from needle insertion toward local anesthetic injection finished
Total sensory dermatomal spread	20 minutes after block performance	The pinprick method at the midclavicular line was used to assess the extent of the dermatomal blockade, 20 minutes following the completion of the procedure by a person who was blinded to group allocation. The total number of dermatomal levels that show decreased pinprick sensation is recorded.A block failure was defined as the absence of any demonstrable sensory block 20 minutes after performance of the block.
Caudal sensory dermatomal spread	20 minutes after block performance	The pinprick method at the midclavicular line was used to assess the extent of the dermatomal blockade, 20 minutes following the completion of the procedure by a person who was blinded to group allocation. The most caudal dermatomal level that show a decreased pinprick sensation is recorded.A block failure was defined as the absence of any demonstrable sensory block 20 minutes after performance of the block.

Trial Locations

Locations (1)

Peking Union Medical College Hospital; 🇨🇳 Beijing, China