ESPB vs PVB vs QLB After Pelvi-ureteric Surgeries

Not Applicable

Completed

• Conditions: Analgesia; Quadratus Lumborum Block; Erector Spinae Plane Block; Paravertebral Block
• Interventions: Procedure: ESPB Technique; Procedure: QLB Technique; Procedure: TPVB Technique

• Registration Number: NCT05713643
• Lead Sponsor: Kafrelsheikh University

Brief Summary

The aim of this study is to compare the analgesic efficacy of erector spinae plane block versus thoracic paravertebral block versus quadratus lumborum block on postoperative analgesia after pelvi-ureteric surgeries.

Detailed Description

Opioid-based analgesia plays a significant role in the control of postsurgical pain; however, use of opioid may lead to significant side effects (e.g., nausea and vomiting) and adverse events (e.g. respiratory depression), which may be associated with significantly longer hospital stays and higher hospital costs in the postsurgical setting .

Thoracic paravertebral block (TPVB) is a classic trunk block with definite analgesic effect for both somatic and visceral pain.

Quadratus Lumborum block (QLB) is a widely used regional anesthesia technique as well. It has been used for reducing postoperative pain after cesarean section, laparotomy or laparoscopic procedure and hip surgery.

Erector spinae plane block (ESPB) is a novel inter-fascial plane block first introduced by Forero et al. in 2016 , providing wide-ranging analgesia in lung surgery, laparoscopy, mastectomy, and pediatric surgery. The proposed mechanism of ESPB is that distribution of local anesthetic solution spreads into the para-vertebral space and epidural space, which then blocks the dorsal, ventral, and traffic branches of spinal nerve.

ESPB, TPVB and QLB III have been shown to improve analgesic outcome after urological surgeries.

Study Timeline

• Study First Submitted: 2023-01-26
• Study Start: 2023-01-30
• Study First Submitted QC: 2023-02-03
• Study First Posted: 2023-02-06
• Status Verified: 2023-11
• Primary Completion: 2023-11-05
• Study Completion: 2023-11-05
• Last Update Submitted: 2023-11-21
• Last Update Posted: 2023-11-22

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 90

Inclusion Criteria

• Age 18-65 years
• Both genders
• American Society of Anesthesiologists (ASA) physical status I-III
• Undergoing elective pelvi-ureteric surgeries.

Exclusion Criteria

• Body Mass Index > 30 kg/m2.
• Contraindication of deep nerve block such as allergic to anesthetic drug, coagulation disorder, and infection at the injection site.
• Chronic opioids dependence or chronic pain over 3 months.
• Use of medication such as gabapentin-pregabalin could affect pain perception.
• Unable to communicate preoperatively due to severe dementia, language barrier, or neuropsychiatric disorder.
• Unable to perform nerve block procedure due to difficult anatomy through ultrasound scan.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
ESPB group	ESPB Technique	-
QLB group	QLB Technique	-
TPVB group	TPVB Technique	-

Primary Outcome Measures

Name	Time	Method
The total postoperative morphine consumption	48 hours postoperatively	Total amount of rescue analgesic in the first 48 hours postoperative will be measured.

Secondary Outcome Measures

Name	Time	Method
Patients' satisfaction after surgery.	48 hours Postoperatively	The degree of patient satisfaction will be assessed on a 5-point scale: (0= extremely dissatisfied, 1= unsatisfied, 2= neither satisfied nor unsatisfied, 3= satisfied), 4= extremely satisfied).
Access time of first analgesic	48 hours Postoperatively	The time to first request of rescue analgesia will be recorded
Access post-operative pain scores	48 hours Postoperatively	Postoperative pain will be accessed using Numeric Rating Scale which ranges from 0 to 10 points, with 0 indicating no pain, 1-3 indicating mild pain, 4-6 indicating moderate pain, and 7-10 indicating severe pain.

Trial Locations

Locations (1)

Mohammad Fouad Algyar; 🇪🇬 Tanta, ElGharbiaa, Egypt