Comparison of Quadratus Lumborum Intramuscular and Transmuscular in Postoperative Pain

Not Applicable

Completed

• Conditions: Pain, Postoperative; Pain, Acute; Cesarean Section Complications
• Interventions: Other: Quadratus lumborum block after C-section surgery as postoperative pain management

• Registration Number: NCT05005871
• Lead Sponsor: Udayana University

Brief Summary

Acute pain is reported in approximately 80% of patients undergoing postoperative care for various types of surgical procedures in the United States. Another study reported patient postoperative pain intensity with 75% with severe pain in the first 1 to 2 postoperative days and 38% reporting moderate to severe pain at 14 postoperative days. Several modalities have been used as the standard for the management of pain postoperative C-sections.

One of the postoperative analgesic modalities for SC is quadratus lumborum block (QLB). This technique has advantages in relieving postoperative pain after C-section because it is considered to be able to relieve visceral pain as well as somatic pain. The transmuscular QLB (QLBT) approach is one of the most frequently used. This technique was found to be effective with regard to the distribution of analgesics to the paravertebral spaces which is the hallmark of QLB. However, this technique was found to be difficult to perform. Difficulties were reported related to the position of the procedure i.e. lateral or sitting position.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2021-06-15
• Study First Submitted QC: 2021-08-10
• Study First Posted: 2021-08-16
• Study Start: 2021-09-01
• Primary Completion: 2021-09-30
• Status Verified: 2021-10
• Study Completion: 2021-10-14
• Last Update Submitted: 2021-10-18
• Last Update Posted: 2021-10-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 48

Inclusion Criteria

• Underwent C-section with subarachnoid block
• Aged 18-35 years old.
• ASA preoperative physical status 1-2

Exclusion Criteria

• Coagulopathy
• Anatomic abnormalities of the abdomen
• History of allergy to local anesthesia
• History of hyperalgesia
• History of drug abuse (sedatives, opioids, paracetamol, or other pain relievers)
• Require postoperative intensive care
• Refuse to participate in research.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Quadratus lumborum intramuscular block	Quadratus lumborum block after C-section surgery as postoperative pain management	The quadratus lumborum intramuscular block will be performed immediately at the end of the surgery. Administration of 0.4 mL of 0.25% bupivacaine will be carried out under ultrasound guidance and performed by experienced anesthesiologists.
Quadratus lumborum transmucular block	Quadratus lumborum block after C-section surgery as postoperative pain management	The quadratus lumborum transmuscular block will be performed immediately at the end of the surgery. Administration of 0.4 mL of 0.25% bupivacaine will be carried out under ultrasound guidance and performed by experienced anesthesiologists.

Primary Outcome Measures

Name	Time	Method
Postoperative pain	Up to 24 hours after surgery	Postoperative pain intensity measured by Visual Analog Scale (VAS), 0=no pain, 100=worst pain
Postoperative morphine requirements	Up to 72 hours after surgery	Total delivered morphine dose after surgery to alleviate postoperative pain (measured by total delivered dose recorded on the Patient-Controlled Analgesia tool)

Trial Locations

Locations (1)

Sanglah General Hospital; 🇮🇩 Denpasar, Bali, Indonesia