Ultrasound Guided Quadratus Lumborum Block for Postoperative Pain in Abdominoplasty: A Randomized Controlled Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- Cumulative morphine consumption
研究概览
简要总结
The original concept of a quadratus lumborum block (QLB) indicated for analgesia after abdominal surgery was first described by Blanco in 2007. Also referred to as a posterior transversus abdominis plane (TAP) block, the QLB consists in deposition of local anesthetic on either the posterior or the anterolateral border of the quadratus lumborum muscle. TAP blocks have already been proved effective in urologic, abdominal, and gynecologic procedures by blocking the sensory nerve supply to the anterior abdominal wall thus reducing the amount of postoperative analgesic medication. The main advantages of QLB compared to the TAP block is a wider sensory block area and a longer duration of analgesia. This is due to the extension of local anesthetic agents beyond the TAP plane to the thoracic paravertebral space(4).
Previous reports have shown that QLB is effective in providing pain relief after various abdominal operations. However, there are no published reports on QLB for postoperative pain after abdominoplasty. This prospective, randomized, double-blinded, controlled study aims to evaluate the analgesic efficacy, opioids consumption and quality of recovery of QLB in patients undergoing abdominoplasty. Patients scheduled to have abdominoplasty will be randomized to receive bilateral QLB with either ropivacaine 0.2% or normal saline. Post-operative cumulative analgesic medication consumption, pain severity at rest and on movement, as well as quality of recovery will be evaluated and compared in both groups.
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
- Triple (Participant, Care Provider, Investigator)
入排标准
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Standard abdominoplasty procedure
- •Written informed consent
- •Age ≥ 18 years
排除标准
- •Patient's refusal
- •Allergies to any study medication
- •Inability to comprehend or participate in scoring scales
- •Deformations that could possibly affect the spread of the local anesthetic in the quadratus lumborum muscle plane
- •Quadratus lumborum muscle plane not seen in ultrasound examination
- •Coagulopathy or on anticoagulants
研究组 & 干预措施
QLB group
Patients will receive at the beginning of the surgery 0.2 ml/kg of 0.2% ropivacaine bilaterally.
Procedure: Quadratus Lumborum Block type II, local anesthetic injection on the posterior border of the quadratus lumborum muscle Drug: Ropivacaine, 0.2 ml/kg of 0.2% ropivacaine
干预措施: QLB bloc (Procedure)
QLB group
Patients will receive at the beginning of the surgery 0.2 ml/kg of 0.2% ropivacaine bilaterally.
Procedure: Quadratus Lumborum Block type II, local anesthetic injection on the posterior border of the quadratus lumborum muscle Drug: Ropivacaine, 0.2 ml/kg of 0.2% ropivacaine
干预措施: 0.2% Ropivacaine (Drug)
Control group
Patients will receive at the beginning of the surgery 0.2 ml/kg of 0.9% normal saline bilaterally.
Procedure: Quadratus Lumborum Block type II, local anesthetic injection on the posterior border of the quadratus lumborum muscle Drug: Normal saline, 0.2 ml/kg of 0.9 % normal saline
干预措施: QLB bloc (Procedure)
Control group
Patients will receive at the beginning of the surgery 0.2 ml/kg of 0.9% normal saline bilaterally.
Procedure: Quadratus Lumborum Block type II, local anesthetic injection on the posterior border of the quadratus lumborum muscle Drug: Normal saline, 0.2 ml/kg of 0.9 % normal saline
干预措施: 0.9% normal saline (Drug)
结局指标
主要结局
Cumulative morphine consumption
时间窗: up to 48 hour
Cumulative morphine consumption in mg while in the PACU and tramadol dose till 48 hour post operatively.
次要结局
- Time to first tramadol dose(up to 48 hour)
- Postoperative pain severity(up to 48 hour)
- Quality of recovery(up to 48 hour)
- Postoperative dynamic pain severity(up to 48 hour)
- Nausea or vomiting(up to 48 hour)
- Sedation level(up to 48 hour)
- Time to first walk(up to 48 hour)
研究者
samer jabbour
MD
St Joseph University, Beirut, Lebanon