Quadratus Lumborum Block vs Transversus Abdominis Plane Block for Post-prostatectomy Analgesia

Not Applicable

Terminated

• Conditions: Prostatic Cancer; Pain, Postoperative; Pain; Anesthetics, Local
• Interventions: Diagnostic Test: Quadratus Lumborum block; Diagnostic Test: Tranversus Abdominis plane block; Drug: Bupivacaine

• Registration Number: NCT03606889
• Lead Sponsor: Jagiellonian University

Brief Summary

Recently, the uses of peripheral axial blocks that deliver local anesthetic into the transversus abdominis fascial plane have become popular for operations that involve incision(s) of the abdominal wall. Thus, the Transversus Abdominis plane (TAP) block has been shown to reduce perioperative opioid use in elective abdominal surgery, including open appendicectomy, laparotomy, and laparoscopic cholecystectomy.

Currently, the Quadratus Lumborum block (QL block) is performed as one of the perioperative pain management procedures for all generations (pediatrics, pregnant, and adult) undergoing abdominal surgery. The local anesthetic injected via the approach of the posterior QL block ( QL 2 block ) can more easily extend beyond the TAP to the thoracic paravertebral space or the thoracolumbar plane, the posterior QL block entails a broader sensory-level analgesic and may generate analgesia from T7 to L1. Use of posterior QL block in laparoscopic prostatectomy has not been investigated before and it is the variant that will be discussed in our study.

Detailed Description

In laparoscopic prostatectomy, overall pain is a conglomerate of three different and clinically separate components: incisional pain (somatic pain), visceral pain (deep intra abdominal pain), and shoulder pain due to peritoneal stretching and diaphragmatic irritation associated with carbon dioxide insufflation. Moreover, it has been hypothesized that intense acute pain after laparoscopic prostatectomy may predict development of chronic pain. Without effective treatment, this ongoing pain may delay recovery, mandate inpatient admission, and thereby increase the cost of such care.

Study Timeline

• Study First Submitted: 2018-07-11
• Study First Submitted QC: 2018-07-30
• Study Start: 2018-07-31
• Study First Posted: 2018-07-31
• Primary Completion: 2021-12-31
• Study Completion: 2021-12-31
• Status Verified: 2022-06
• Last Update Submitted: 2022-06-02
• Last Update Posted: 2022-06-06

Recruitment & Eligibility

• Status: TERMINATED
• Sex: Male
• Target Recruitment: 12

Inclusion Criteria

• Pateints who will have prostatectomy ASA II or III

Exclusion Criteria

Patient refusal Local infection at the site of injection Allergy to study medications Sepsis Anatomic abnormalities Systemic anticoagulation or coagulopathy Inability to comprehend or participate in pain scoring system Inability to use intravenous patient controlled analgesia

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Quadratus Lumborum block group	Quadratus Lumborum block	Quadratus Lumborum block group (QL) patients will receive a bilateral Quadratus Lumborum block using Bupivicaine 0.125%
Transversus abdominis plane block group	Tranversus Abdominis plane block	Transversus abdominis plane block (TAP) patients will receive a bilateral TAP block using Bupivicaine 0.125%
Quadratus Lumborum block group	Bupivacaine	Quadratus Lumborum block group (QL) patients will receive a bilateral Quadratus Lumborum block using Bupivicaine 0.125%
Transversus abdominis plane block group	Bupivacaine	Transversus abdominis plane block (TAP) patients will receive a bilateral TAP block using Bupivicaine 0.125%

Primary Outcome Measures

Name	Time	Method
Total oxycodone used in the first 24 hours after surgery	24 hours	Total cumulative oxycodone dose in mg used in the first 24 hours after surgery

Secondary Outcome Measures

Name	Time	Method
Severity of postoperative pain via visual analogue pain scale (VAS)	24 hours	VAS range from 0 for no pain to 10 for worst pain imaginable

Trial Locations

Locations (1)

University Hospital in Cracow; 🇵🇱 Kraków, Poland