Randomized Prospective Study to Evaluate Cranial Dermatomal Spread of Modified Paramedic Sagittal Versus Transverse Approach TMQLB for Adrenal Surgery
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Cephalic sensory dermatomal spread
研究概览
简要总结
The classical transmuscular qudratus lumborum block(TMQLB) described by Borglum aims to provide lower thoracic paravertebral space(PVS) and sympathetic blockade by injecting local anesthetics between QL and PM muscle at the L3-L4 vertebral level using a transverse scan, posterior-anterior, in-plane approach. Recently, a paramedian sagittal oblique(TMQLB) approach has been introduced to facilitate cranial spread by injecting the local in a caudal to cranial direction. Currently, there are no data comparing the two techniques mentioned above with regards to extent of spread for PVS. Our objective is to investigate the extent of cranial dermatomal spread of TMQLB when equal dosage(ml/kg) of local anesthetic are injected with the transverse versus an modified paramedian sagittal approach for patients undergoing laparoscopic adrenalectomy. In addition, the investigators wish to compare the performance time, caudal dermatomal spread of TMQLB and postoperative analgesia effect.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Triple (Participant, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 18-70 yrs
- •American Society of Anesthesiologists physical statusⅠ-Ⅲ
- •Undergo laparoscopic adrenalectomy
- •Informed consent
- •Able to cooperate with study process
排除标准
- •Allergy to local anesthetic and other medications used in the study
- •Patient refusal or lack of informed consent
- •Coexisting hematological disorder or with deranged coagulation parameters
- •Pre-existing major organ dysfunction such as hepatic and renal failure
- •History of previous renal surgery.
研究组 & 干预措施
transverse TMQLB
Patients in this group will receive the transmuscular quadratus lumborum block before surgery using the transverse scan, in-plain, posterior to anterior approach. 0.6ml 0.375% ropivocaine was injected when the correct needle location is confirmed.
干预措施: transverse scan, in-plane, posterior-anterior TMQLB (Procedure)
paramedian sagittal TMQLB
Patients in this group will receive the transmuscular quadratus lumborum block before surgery using the para-sagittal scan, in-plain, caudal to cephalic approach.0.6ml 0.375% ropivocaine was injected when the correct needle location is confirmed.
干预措施: paramedian sagittal scan, in-plane, caudal-cranial TMQLB (Procedure)
结局指标
主要结局
Cephalic sensory dermatomal spread
时间窗: 20 minutes after block performance
次要结局
- cumulative rate of rescue analgesics usage(At 0,2,4,8,12,24,48 hours after surgery)
- Time to performance of procedure(Duration of procedure)
- Total sensory dermatomal spread(20 minutes after block performance)
- Caudal sensory dermatomal spread(20 minutes after block performance)
- Incidence of complication(Within 48hours after surgery)
- NRS pain scores(At 0,2,4,8,12,24,48hours after surgery)
研究者
Cui Xulei
Attending physician
Peking Union Medical College Hospital