MedPath

Comparison of Quadratus Lumborum Block Types

Phase 3
Recruiting
Conditions
Opioid Use
Pain
Lumbar Disc Herniation
Interventions
Registration Number
NCT04588389
Lead Sponsor
Eman Nada
Brief Summary

This study will compare the quality of analgesia and reduction of opioid use, between standard of care and two groups of local anesthetic blocks in different location in the quadratus lumborum plane, for postoperative pain control after lumbar spinal fusion and if it reduces opioid consumption.

Detailed Description

This study is a pilot study as part of planning for a larger randomized controlled trial. The study plans to enroll a total of 30 patients, with 10 patients randomly assigned in each group of the study. Group I will receive the standard of care multimodal pharmacological management. Group II will receive standard of care multimodal pharmacological management plus the Quadratus Lumborum II local anesthetic block. Group III will receive standard of care multimodal pharmacological management plus the Quadratus Lumborum III local anesthetic block. Measurements of opioid use, pain, and side effects will be recorded for each patient.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Adult Patients undergoing lumbar spinal fusion surgery.
  • Patients from 40-80 years.
Exclusion Criteria
  • Recent drug abuse
  • History of illicit drug use
  • Chronic pain patients not related to the back lesions.
  • Opioid tolerant patients.
  • Patients with any lower extremity weaknesses or deficits.
  • Patients with American Society of Anesthesiologists (ASA) classification more than 3.
  • Coagulopathy.
  • Infection near or in the area of the block.
  • Pregnant patients.
  • Uncooperative patients who refuse care which directly effects research participation or clinical care.
  • If the surgeon reports performing non-typical fusion.
  • The presence of intraoperative complications like nerve injury or abnormal results of neuromonitoring and extensive dissection.
  • Vulnerable populations (prisoner, mental impairment / dementia, pregnant, etc.)
  • Subjects on chronic buprenorphine therapy (either for opioid replacement or pain control)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group 2 Standard of Care + Quadratus Lumborum Block IIIRopivacaine injection Location 2Group III will receive standard of care multimodal pharmacological management plus the Quadratus Lumborum III local anesthetic block. We will measure opioid use, pain, and side effects in each patient.
Group 2 Standard of Care + Quadratus Lumborum Block IIIMultimodal Pharmacological ManagementGroup III will receive standard of care multimodal pharmacological management plus the Quadratus Lumborum III local anesthetic block. We will measure opioid use, pain, and side effects in each patient.
Group 1 Standard of CareMultimodal Pharmacological ManagementGroup I will receive the standard of care multimodal pharmacological management.
Group 2 Standard of Care + Quadratus Lumborum Block IIRopivacaine injection Location 1Group II will receive standard of care multimodal pharmacological management plus the Quadratus Lumborum II local anesthetic block.
Group 2 Standard of Care + Quadratus Lumborum Block IIMultimodal Pharmacological ManagementGroup II will receive standard of care multimodal pharmacological management plus the Quadratus Lumborum II local anesthetic block.
Primary Outcome Measures
NameTimeMethod
Opioid Consumption48 hours

Dose of the opioids consumed

Secondary Outcome Measures
NameTimeMethod
Discharge Opioid Use2 weeks

The amount of left-over opioid pills at 2 weeks in the follow up visit.

Pain Scale48ours

Numerical Pain Scale Rating, likert scale of 0-10 with a 0 indicating absence of pain and 10 indicating worst pain imaginable.

Side EffectsUp to 1 week

The presence of any side effects reported.

Trial Locations

Locations (1)

UMASS Memorial Medical Center

🇺🇸

Worcester, Massachusetts, United States

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