Transmuscular Quadratus Lumborum Block for Postoperative Pain After Total Abdominal Hysterectomy
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 64
- 试验地点
- 1
- 主要终点
- Pain score at rest and movement
研究概览
简要总结
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 20 Years 至 65 Years（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •ASA I or II
- •Patient's weight > 50kg
- •Elective TAH
排除标准
- •Body mass index (BMI) > 35 kg/m2
- •Any contraindications to peripheral nerve blocks i.e. local skin infection, coagulopathy, allergy to LA
- •Inability to use patient controlled analgesia
- •Patient on antiplatelet, anticoagulant or on regular use of opioids, paracetamol, nonsteroidal anti-inflammatory drugs or tramadol for chronic condition
研究组 & 干预措施
Transmuscular quadratus lumborum (QL) 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
干预措施: Transmuscular quadratus lumborum block (Procedure)
Transmuscular quadratus lumborum (QL) 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
干预措施: morphine (Drug)
Transmuscular quadratus lumborum (QL) 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
干预措施: ropivacaine (Drug)
Control
Patient controlled analgesia morphine (1mg/bolus morphine, lockout time 5 minutes) post operative
干预措施: morphine (Drug)
结局指标
主要结局
Pain score at rest and movement
时间窗: 24 hours after total abdominal hysterectomy
using visual analogue scale 1 to 10
Cumulative morphine consumption
时间窗: 24 hours after total abdominal hysterectomy
in mg for 24 hours
次要结局
- Complications related to the transmuscular QL block(24 hours after total abdominal hysterectomy)
研究者
Amiruddin Nik Mohamed Kamil
Dr
Kuala Lumpur General Hospital