COMPARISON OF ERECTOR SPINAE PLANE BLOCK, QUADRATUS LUMBORUM BLOCK, AND TRANSVERSUS ABDOMINIS PLANE BLOCK IN POSTOPERATIVE PAIN MANAGEMENT IN GYNECOLOGICAL ABDOMINAL SURGERIES
Trial Snapshot
- Phase
- Not Applicable
- Status
- Enrolling By Invitation
- Sponsor
- Cukurova University
- Enrollment
- 80
- Locations
- 1
- Primary Endpoint
- morphine consumption in the postoperative period
Study Overview
Brief Summary
This study compares the effects of transversus abdominis plane (TAP) block, quadratus lumborum block (QLB), and erector spinae plane block (ESP) on postoperative morphine consumption, pain scores, patient satisfaction, and side effects in patients undergoing gynecological abdominal laparotomy surgeries.
Detailed Description
Patients will be randomly assigned into four groups using a computer-generated randomization method. According to group allocation, patients will receive the following interventions before extubation under ultrasound (US) guidance except control group:
Group E (n=20): Bilateral erector spinae plane (ESP) block will be performed with 40 ml of 0.25% bupivacaine (20 ml on each side) at the T12 level, approximately 3-4 cm laterally from the midline, in the neurofascial plane between the transverse processes and the erector spinae muscle.
Group Q (n=20): Bilateral quadratus lumborum block (QLB) will be performed with 40 ml of 0.25% bupivacaine (20 ml on each side), placed between the psoas major and quadratus lumborum muscles under US guidance, between the iliac crest and the 12th rib.
Group T (n=20): Bilateral transversus abdominis plane (TAP) block will be performed with 40 ml of 0.25% bupivacaine (20 ml on each side) in the neurofascial plane between the internal oblique and transversus abdominis muscles.
Group C (Control group, n=20): No block will be applied, only the standard intravenous patient-controlled analgesia (PCA) protocol will be used.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Sequential
- Primary Purpose
- Treatment
- Masking
- Single (Investigator)
Eligibility Criteria
- Ages
- 18 Years to 69 Years (Adult, Older Adult)
- Sex
- Female
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •aged between 18 and 69 years, with ASA 1-2 score scheduled to undergo major gynecological abdominal surgery
Exclusion Criteria
- •ASA score 3 or above, patients younger than 18 or older than 69 years, patients with bleeding disorders or using anticoagulants, patients with a body mass index over 40, patients with known allergies to any drugs used in the study, and patients who could not or did not wish to use Patient-Controlled Analgesia (PCA) device
Arms & Interventions
Group Q
Group QLB & ESP, TAP, Control
Intervention: ESP Plane block (Procedure)
Group Q
Group QLB & ESP, TAP, Control
Intervention: TAP Block (Procedure)
Group T
Group T & ESP, QLB, Control
Intervention: ESP Plane block (Procedure)
Group T
Group T & ESP, QLB, Control
Intervention: QLB plane block (Procedure)
Group C
Group C & ESP, QLB, TAP
Group E
Group ESP & QLB, TAP, Control
Intervention: QLB plane block (Procedure)
Group E
Group ESP & QLB, TAP, Control
Intervention: TAP Block (Procedure)
Group T
Group T & ESP, QLB, Control
Intervention: No intervention (Other)
Group Q
Group QLB & ESP, TAP, Control
Intervention: No intervention (Other)
Group E
Group ESP & QLB, TAP, Control
Intervention: No intervention (Other)
Outcomes
Primary Outcomes
morphine consumption in the postoperative period
Time Frame: For postoperative 24 hours
Thus the primary aim of this study was to assess the morphine consumption in the postoperative period
Secondary Outcomes
- pain score (VAS=0-10), patient satisfaction (0-10), the need for rescue analgesia (mg) and side effects(For postoperative 24 hours)
Investigators
Hakki Unlugenc
Prof Dr
Cukurova University