Comaprison Between QLB and ESPB in Patients for PCNL Operation

Not Applicable

Completed

• Conditions: Pain, Postoperative
• Interventions: Procedure: Subcostal Oblique Quadratus Lumborum Block and Erector Spinae Plain Block.

• Registration Number: NCT04277611
• Lead Sponsor: Assiut University

Brief Summary

comparing the subcostal oblique Quadratus Lumborum block and the Erector Spinae plane block in patients undergoing percutaneous nephrolithotomy operation to get the best and longest postoperative analgesic effect.

Detailed Description

Here the investigators are going to compare between the Anterior approach for the subcostal oblique Quadratus Lumborum block (QLB) and the Erector Spinae Plane Block (ESPB) to determine their level of spread and their value in controlling postoperative pain in patients scheduled for Percutaneous Nephrolithotomy surgery. We hypothesized that quadratus lumborum is not inferior regarding the duration of analgesia when compared to erector spinae in patients undergoing percutaneous nephrolithotomy under general anesthesia.

Study Timeline

• Study First Submitted: 2020-02-18
• Study First Submitted QC: 2020-02-19
• Study First Posted: 2020-02-20
• Study Start: 2021-04-20
• Primary Completion: 2022-06-01
• Study Completion: 2022-06-30
• Status Verified: 2022-09
• Last Update Submitted: 2022-09-04
• Last Update Posted: 2022-09-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 92

Inclusion Criteria

• Both sex
• Age: 18-60
• ASA (American Society of Anesthesiologists) class I and II
• Elective surgery
• Patients undergoing PNL surgery

Exclusion Criteria

• Patient's refusal
• Allergy or contraindications to drugs used in the study
• Emergency surgery
• Psychiatric disorders
• Severely co-morbid patients
• Inflammation or infection over injection site
• Bleeding diathesis; INR more than 1.5 and Platelet count less than 100,000/mm3
• Peripheral neuropathy
• Obese patients BMI ≥35
• Patients on previous opioid therapy
• Pre-operative haemoglobin <10 mg/dl
• Inability to properly describe postoperative pain to investigators
• Coagulation abnormalities
• History of drug addiction or alcohol abuse
• History of Previous renal surgery

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
QLB	Subcostal Oblique Quadratus Lumborum Block and Erector Spinae Plain Block.	The patient is in the prone position, an ultrasound probe is placed in a transverse, oblique, and paramedian orientation approximately lateral to the posterior axillary line. The needle is then inserted in-plane from the medial side of the transducer and advanced laterally to enter the interfascial plane between the Quadratus Lumborum muscle and the kidney. We confirmed that the local anesthetic appeared to press down the kidney in the ultrasound image
ESPB	Subcostal Oblique Quadratus Lumborum Block and Erector Spinae Plain Block.	Using aseptic technique, an ultrasound probe is placed at the T9 vertebral level. After identifying the ribs and sliding towards the midline in a longitudinal parasagittal orientation, the overlying Erector Spinae is identified by visualization of the transition between the rib and transverse apophysis a block needle is inserted in plane with ultrasound beam and is advanced in a cephalo-caudal direction until the tip contacted the transverse process.

Primary Outcome Measures

Name	Time	Method
Analgesia	48 hours	Total opioid consumption during the first 48hours postoperatively.

Secondary Outcome Measures

Name	Time	Method
Analgesia	24 hours	first Analgesic request postoperatively.
episodes of nausea and vomiting	within 24 hours postoperative	to investigate if there is or not.
patient satisfaction with anesthesia	48 hours postoperative.	Patient satisfaction with anesthesia was assessed using a 5-point scale (5: very satisfied; 4: satisfied; 3: neither satisfied nor dissatisfied; 2: dissatisfied; 1: very dissatisfied)
time of recovery of bowl movement	5 days postoperative	time from the end of the surgery to the first time of bowl movement
Pain Scores using Visual Analog Scale (VAS) Scores	24 hours postoperative.	VAS is a scale to determine the patient's pain level.
postoperative length of hospital stay	within 2 weeks postoperative.	till time of discharge
ambulation time	5 days postoperative	time from the end of the surgery to the first time to out-of-bed activity

Trial Locations

Locations (1)

Assiut University Hospitals; 🇪🇬 Assiut, Egypt