Modified Paramedic Sagittal vs. Transverse TMQLB

Not Applicable

Completed

• Conditions: Nerve Block
• Interventions: Procedure: transverse scan, in-plane, posterior-anterior TMQLB; Procedure: paramedian sagittal scan, in-plane, caudal-cranial TMQLB

• Registration Number: NCT03771742
• Lead Sponsor: Peking Union Medical College Hospital

Brief Summary

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.

Detailed Description

Not available

Study Timeline

• Study Start: 2018-09-15
• Study First Submitted: 2018-12-09
• Study First Submitted QC: 2018-12-09
• Study First Posted: 2018-12-11
• Primary Completion: 2019-02-14
• Study Completion: 2019-02-17
• Status Verified: 2019-04
• Last Update Submitted: 2019-04-15
• Last Update Posted: 2019-04-16

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

• Age 18-70 yrs
• American Society of Anesthesiologists physical statusⅠ-Ⅲ
• Undergo laparoscopic adrenalectomy
• Informed consent
• Able to cooperate with study process

Exclusion Criteria

• 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.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
transverse TMQLB	transverse scan, in-plane, posterior-anterior 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.
paramedian sagittal TMQLB	paramedian sagittal scan, in-plane, caudal-cranial 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.

Primary Outcome Measures

Name	Time	Method
Cephalic sensory dermatomal spread	20 minutes after block performance

Secondary Outcome Measures

Name	Time	Method
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	patients will evaluate their pain intensity with the numerical rating scale (NRS), where 0 indicates no pain, and 10 indicates the most severe pain.

Trial Locations

Locations (1)

Peking Union Medical College Hospital; 🇨🇳 Beijing, China