Postoperative Analgesia With Transversus Abdominis Plane Block or Quadratus Lumborum Block in Patients After Cesarian Delivery
Overview
- Phase
- Phase 4
- Intervention
- Morphine
- Conditions
- Cesarean Section
- Sponsor
- Medical University of Lublin
- Enrollment
- 105
- Locations
- 1
- Primary Endpoint
- Postoperative pain
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
Comparison of two types of analgesia after cesarean section All patients will be anesthetized with spinal technique. Ultrasound-guided transversus abdominis plane or quadratus lumborum block to treat postoperative pain. Postoperative pain will be measured with visual-analog scale (VAS). 1, 2, 6 months after surgery each patient will be called to assess neuropathic pain with Neuropathic Pain Symptom Inventory (NPSI).
Detailed Description
Written consent will be obtained before the cesarean section. Only subarachnoidally anesthetized patients may participate in the study. Pencil-point spinal needle and bupivacaine (Marcaine Heavy Spinal 0.5 %) will be used. At the end of surgery ultrasound-guided regional block will be performed. Each patient will be randomly allocated to one of the treated group: transversus abdominis plane block (TAP) or quadratus lumborum (QL). Patients receive 0.2 mL of local anesthetic solution (0.375 % ropivacaine) on each side. Postoperative pain will be measured with VAS (visual-analog scale) 2, 4, 8, 12 and 24 hours after the end of the operation. Paracetamol, metamizole, ketoprofen may be given as required. Whenever pain exceeds 40 (VAS) 5 mg of morphine will be given intravenously (maximum two dosages per day). 1, 3, 6 months patients will be called to assess neuropathic pain. Neuropathic Pain Symptom Inventory (NPSI) will be used.
Investigators
Michał Borys
associate professor
Medical University of Lublin
Eligibility Criteria
Inclusion Criteria
- •obtained consent
- •singleton pregnancy
- •subarachnoid anesthesia
Exclusion Criteria
- •coagulopathy
- •allergy to local anesthetics
- •depression, antidepressant drugs treatment
- •usage of painkiller before surgery
- •addiction to alcohol or recreational drugs
Arms & Interventions
TAP
Ultrasound-guided transversus abdominis plane block at the end of cesarean section
Intervention: Morphine
TAP
Ultrasound-guided transversus abdominis plane block at the end of cesarean section
Intervention: TAP (transversus abdominis plane block)
TAP
Ultrasound-guided transversus abdominis plane block at the end of cesarean section
Intervention: Ropivacaine
TAP
Ultrasound-guided transversus abdominis plane block at the end of cesarean section
Intervention: Needle
TAP
Ultrasound-guided transversus abdominis plane block at the end of cesarean section
Intervention: paracetamol
TAP
Ultrasound-guided transversus abdominis plane block at the end of cesarean section
Intervention: metamizole
TAP
Ultrasound-guided transversus abdominis plane block at the end of cesarean section
Intervention: Ketoprofen
QLB
Ultrasound-guided quadratus lumborum block at the end of cesarean section
Intervention: QL (quadratus lumborum block)
QLB
Ultrasound-guided quadratus lumborum block at the end of cesarean section
Intervention: Ropivacaine
QLB
Ultrasound-guided quadratus lumborum block at the end of cesarean section
Intervention: Needle
QLB
Ultrasound-guided quadratus lumborum block at the end of cesarean section
Intervention: paracetamol
QLB
Ultrasound-guided quadratus lumborum block at the end of cesarean section
Intervention: metamizole
QLB
Ultrasound-guided quadratus lumborum block at the end of cesarean section
Intervention: Ketoprofen
QLB
Ultrasound-guided quadratus lumborum block at the end of cesarean section
Intervention: Morphine
Outcomes
Primary Outcomes
Postoperative pain
Time Frame: up to 24 hours after the surgery
Acute pain measured with VAS (visual-analogue scale). VAS in milimmeters. Minimum value 0, maximum 100. Less better - less severe pain. 0 no pain at all.
Secondary Outcomes
- Neuropathic pain(6 months from the surgery)