Postoperative Analgesia of Quadratus Lumborum Block Versus Epidural Block After Major Abdominal Surgeries

Not Applicable

Completed

• Conditions: Elective Major Abdominal Surgery
• Interventions: Other: Thoracic epidural block; Other: Ultrasound-guided bilateral quadratus lumborum block; Drug: Induction of general anaesthesia with propofol; Drug: Muscle Relaxant; Drug: Maintenance of general anaesthesia

• Registration Number: NCT04541732
• Lead Sponsor: Mansoura University

Brief Summary

Acute postoperative pain is an important issue after major abdominal surgeries for which different analgesic modalities have been tried.

Epidural analgesia is the recommended technique to relieve pain after major abdominal surgeries owing to the proved superior analgesia, reduction of opioid-related side effects as nausea, vomiting, pruritis and sedation, earlier recovery of bowel function and earlier ability for postoperative mobility. However, it is not without complications.

Quadratus lumborum block is an ultrasound-guided block that provides patients with both visceral and somatic blockade. It lessens the potential risks associated with neuraxial techniques, so it may represent a novel alternative approach for analgesia after major abdominal surgeries.

Detailed Description

The aim of this study is to detect the feasibility of ultra-sound guided bilateral quadratus lumborum block as a postoperative analgesic modality after major abdominal surgery in comparison to epidural block and its effects on total rescue analgesic requirements in the 1st postoperative 24hours, time to first analgesic request, pain VAS scores, intraoperative and postoperative hemodynamics and postoperative opioid-related side effects.

Under complete aseptic conditions, the patients will receive either thoracic epidural block or bilateral ultrasound-guided quadratus lumborum block after induction of general anaesthesia

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study Start: 2019-01-01
• Primary Completion: 2019-04-09
• Study Completion: 2019-05-06
• Status Verified: 2020-09
• Study First Submitted: 2020-09-02
• Study First Submitted QC: 2020-09-02
• Last Update Submitted: 2020-09-02
• Study First Posted: 2020-09-09
• Last Update Posted: 2020-09-09

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 80

Inclusion Criteria

• American Society of Anesthesiologists (ASA) physical status I-III

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Exclusion Criteria

• Patient's refusal
• Significant cardiac, disease.
• Significant hepatic disease.
• Significant renal disease (serum creatinine ˃ 1.5 mg/dl).
• Patients with drug abuse
• Allergy to study medications
• Mental disease
• Communication barrier.
• Coagulopathy.
• Local skin infection

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Thoracic epidural block	Thoracic epidural block	Patients will receive thoracic epidural block following induction of general anaesthesia
Thoracic epidural block	Induction of general anaesthesia with propofol	Patients will receive thoracic epidural block following induction of general anaesthesia
Thoracic epidural block	Muscle Relaxant	Patients will receive thoracic epidural block following induction of general anaesthesia
Thoracic epidural block	Maintenance of general anaesthesia	Patients will receive thoracic epidural block following induction of general anaesthesia
Bilateral quadratus lumborum block	Ultrasound-guided bilateral quadratus lumborum block	Patients will receive Ultrasound-guided bilateral quadratus lumborum block following induction of general anaesthesia
Bilateral quadratus lumborum block	Induction of general anaesthesia with propofol	Patients will receive Ultrasound-guided bilateral quadratus lumborum block following induction of general anaesthesia
Bilateral quadratus lumborum block	Muscle Relaxant	Patients will receive Ultrasound-guided bilateral quadratus lumborum block following induction of general anaesthesia
Bilateral quadratus lumborum block	Maintenance of general anaesthesia	Patients will receive Ultrasound-guided bilateral quadratus lumborum block following induction of general anaesthesia

Primary Outcome Measures

Name	Time	Method
Postoperative 24 hours cumulative rescue morphine consumption	For 24 hours after surgery

Secondary Outcome Measures

Name	Time	Method
The duration of postoperative analgesia	For 24 hours after surgery	time from performing epidural or quadratus lumborum block till the time for the first rescue morphine request
Postoperative pain score at rest	For 24 hours after surgery	Visual analogue scale to assess the severity of postoperative pain (0 mm for no pain and100 mm for worst imaginable pain)
Systolic blood pressure	For 28 hours after induction of anesthesia
Postoperative pain score on movement	For 24 hours after surgery	Visual analogue scale to assess the severity of postoperative pain (0 mm for no pain and100 mm for worst imaginable pain)
Heart rate	For 28 hours after induction of anesthesia
Degree of postoperative nausea and vomiting	For 24 hours after surgery	Nausea will be measured using a numerical rating system (none= 0; mild= 1; moderate= 2; severe= 3). The number of vomiting episodes and the number of antiemetics received will be recorded
Pruritis	For 24 hours after surgery
Postoperative pain score on cough	For 24 hours after surgery	Visual analogue scale to assess the severity of postoperative pain (0 mm for no pain and100 mm for worst imaginable pain)
Diastolic blood pressure	For 28 hours after induction of anesthesia
Mean blood pressure	For 28 hours after induction of anesthesia

Trial Locations

Locations (1)

Mohammed A Ghanem; 🇪🇬 Mansourah, DK, Egypt