Analgesic Efficacy of Transmuscular Quadratus Lumborum in Patients Undergoing Total Abdominal Hysterectomy

Not Applicable

Completed

• Conditions: Pain Postoperative
• Interventions: Drug: morphine; Procedure: Transmuscular quadratus lumborum block; Drug: ropivacaine

• Registration Number: NCT02586454
• Lead Sponsor: Kuala Lumpur General Hospital

Brief Summary

Patients who have undergone laparotomies often require multimodal postoperative pain regimes. In recent years, abdominal wall blocks have been included to become part of this in order to overcome side effects of systemic opioids and complications from epidural analgesia.

Borglum popularised a new approach on abdominal wall blocks by introducing the transmuscular quadratus lumborum (QL) block. Transmuscular QL block is thought to be effective against somatic and visceral pain as local anaesthetic tends to spread from the site of injection to thoracic paravertebral spaces where the sympathetic chain lies.

The objective of this study is to evaluate the analgesic efficacy of transmuscular QL block in patients undergoing total abdominal hysterectomy (TAH) by measuring cumulative opioid consumption, pain score at rest and on movement 24 hours after TAH. Our hypothesis is patients given transmuscular QL block will have lower cumulative opioid consumption.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2015-10-23
• Study First Submitted QC: 2015-10-23
• Study First Posted: 2015-10-26
• Study Start: 2015-11
• Primary Completion: 2017-01
• Study Completion: 2017-01
• Status Verified: 2017-06
• Last Update Submitted: 2017-06-18
• Last Update Posted: 2017-06-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 64

Inclusion Criteria

1. ASA I or II
2. Patient's weight > 50kg
3. Elective TAH

Exclusion Criteria

1. Body mass index (BMI) > 35 kg/m2
2. Any contraindications to peripheral nerve blocks i.e. local skin infection, coagulopathy, allergy to LA
3. Inability to use patient controlled analgesia
4. Patient on antiplatelet, anticoagulant or on regular use of opioids, paracetamol, nonsteroidal anti-inflammatory drugs or tramadol for chronic condition

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Transmuscular quadratus lumborum (QL) block	ropivacaine	Bilateral QL block using 20 ml 0.375% ropivacaine in each side (to a maximum dose 3 mg/kg) plus patient controlled analgesia morphine (1mg/bolus morphine, lockout time 5 minutes) post operative
Control	morphine	Patient controlled analgesia morphine (1mg/bolus morphine, lockout time 5 minutes) post operative
Transmuscular quadratus lumborum (QL) block	Transmuscular quadratus lumborum block	Bilateral QL block using 20 ml 0.375% ropivacaine in each side (to a maximum dose 3 mg/kg) plus patient controlled analgesia morphine (1mg/bolus morphine, lockout time 5 minutes) post operative
Transmuscular quadratus lumborum (QL) block	morphine	Bilateral QL block using 20 ml 0.375% ropivacaine in each side (to a maximum dose 3 mg/kg) plus patient controlled analgesia morphine (1mg/bolus morphine, lockout time 5 minutes) post operative

Primary Outcome Measures

Name	Time	Method
Pain score at rest and movement	24 hours after total abdominal hysterectomy	using visual analogue scale 1 to 10
Cumulative morphine consumption	24 hours after total abdominal hysterectomy	in mg for 24 hours

Secondary Outcome Measures

Name	Time	Method
Complications related to the transmuscular QL block	24 hours after total abdominal hysterectomy	Complications related to transmuscular QL block: Haematoma at site of injection,infection at site of injection Complications related to PCAM:Nausea, vomiting, pruritus, sedation

Trial Locations

Locations (1)

Hospital Kuala Lumpur; 🇲🇾 Kuala Lumpur, Malaysia