Quadratus Lumborum Block Type III Versus Type II Versus Transversus Abdominis Plane Block in Cesarean Section

Not Applicable

Completed

• Conditions: Quadratus Lumborum Block; Cesarean Section; Transversus Abdominis Plane Block
• Interventions: Procedure: Quadratus lumborum block typen II; Procedure: Transversus abdominis plane block; Procedure: Quadratus lumborum block III

• Registration Number: NCT05950568
• Lead Sponsor: The General Authority for Teaching Hospitals and Institutes

Brief Summary

Compare the type III and type II quadratus lumborum block (QLB) to transversus abdominis plane block (TAPB) regarding efficacy in CS

Detailed Description

The transversus abdominis plane block (TAPB) is administered between the internal oblique muscle and the transversus abdominis muscle in the fascial plane, directly pointing to the somatic nerves T6-L1 that run in this plane. In addition, meta-analyses demonstrate that it is an effective analgesic for somatic pain and diminishes opiate intake. It has been reported that TAPB is an efficient analgesic approach following cesarean section .

The quadratus lumborum (QL) muscle block (QLB) is a fascial plane block as local anesthetic (LA) is introduced nearby to the QL muscle to numb the thoracolumbar nerves. QLB is categorized into four types according to drug administration location, I (lateral), II (posterior), III (anterior/transmuscular), and Intravenous, (intramuscular). QLB can effectively decrease both visceral and somatic pain by LA distribution to the thoracic paravertebral space (TPVS), as this block ensures effective pain control from the T7 to L1 dermatomes. QLB is one of the regional techniques that provides the greatest benefit in post-CS pain control, as it is progressively applied in obstetric anesthetic precise to improve analgesic results.

Study Timeline

• Study Start: 2023-03-24
• Primary Completion: 2023-06-25
• Study Completion: 2023-06-25
• Status Verified: 2023-07
• Study First Submitted: 2023-07-10
• Study First Submitted QC: 2023-07-10
• Study First Posted: 2023-07-18
• Last Update Submitted: 2023-07-22
• Last Update Posted: 2023-07-25

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 60

Inclusion Criteria

• American Society of Anesthesiologists (ASA) physical status II
• aged 18 to 40 years old
• presenting for elective Cesarean section

Exclusion Criteria

• body mass index (BMI) ≥40 kg/m2
• weight < 50kg
• height < 150 cm
• contraindications for the use of active labor, spinal anesthesia
• recent opiate intake
• hypersensitivity to any used medication
• substantial cardiovascular diseases
• renal diseases
• hepatic, diseases.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Quadratus lumborum block type II	Quadratus lumborum block typen II	A 22 gauge needle was positioned between the erector spinae muscle in the thoracolumbar fascia's middle layer
Transversus abdominis plane block	Transversus abdominis plane block	A 22 gauge needle was positioned between the internal oblique and transversus abdominis muscles
Quadratus lumborum block type III	Quadratus lumborum block III	A 22 gauge needle was positioned between the psoas and quadratus lumborum muscles at the anterior fascia lumbosacral

Primary Outcome Measures

Name	Time	Method
Total postoperative consumed pethidine	24 hour postoperatively	Numerical rating scales (NRS) score was evaluated at Post Anesthesia Care Unit (PACU), 2, 4, 6, 8, 12, 18, and 24 hours as as 0 is no pain and 10 is the worst pain imaginable. If the NRS score remained ≥ 4, we provided a bolus pethidine (0.5 mg/kg intravenous) and repeatable after 30 minutes if NRS remains≥ 4.

Secondary Outcome Measures

Name	Time	Method
Time of the first analgesic request	24 hour postoperatively	If the Numerical rating scales (NRS) score remained ≥ 4, we provided a bolus pethidine (0.5 mg/kg intravenous).
Patient satisfaction	24 hour postoperatively	The level of patient satisfaction was graded on a 5-point Likert scale as 0= extremely dissatisfied, 1= dissatisfied, 2= neither satisfied nor dissatisfied, 3= satisfied, 4= extremely satisfied
The degree of postoperative pain	24 hour postoperatively	Numerical rating scales (NRS ) score was evaluated at Post Anesthesia Care Unit (PACU), 2, 4, 6, 8, 12, 18, and 24 hours as as 0 is no pain and 10 is the worst pain imaginable.

Trial Locations

Locations (1)

The General Authority for Teaching Hospitals and Institutes; 🇪🇬 Cairo, Egypt