An Observational study of Anterior Quadratus Lumborum Block in ease of positioning for spinal anesthesia among fracture acetabulum cases at SMS Medical College, Jaipur.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 33
- 试验地点
- 1
- 主要终点
- 1. To assess and compare difference in NRS from baseline , 5 min , 30 min after the block.
研究概览
简要总结
Acetabulum fractures although constitute only 1.5 -3% of geriatric orthopaedic trauma but are on the rise. A large proportion of them are elderly with multiple comorbidities and their associated challenges. It is a painful condition both at rest and on slight movement. good perioperative analgesia is mandatory for these patients, like in any other orthopaedic trauma. Many recipes have been tried for perioperative pain relief ranging from systemic analgesia with or without opioids to multimodal analgesia. Many regional blocks like femoral nerve block, 3 in 1, fascia ilaca, supra inguinal fascia ilaca and peri capsular nerve group block have been tried as part of multimodal analgesia.
These days acetabulum fractures are fixed surgically, anaesthesia of choice for these patients is central neuraxial block and many times combined spinal epidural for both long duration surgeries and postoperative analgesia. For these blocks sitting position is preferable as patients find it difficult to lie on the side. To perform these blocks successfully in one go the patient has to be pain free and comfortable. Systemic analgesia is a choice, but at times it does not offer adequate analgesia and patient sometimes feel a little dizzy if they are given opioids. So we all look forward to good regional blocks for effective analgesia during positioning these patients for central neuraxial blocks.
Blanco introduced the Quadratus Lumborum block in 2007 and it is now emerging as new regional block that has performed favourably in lower abdominal surgery and is being evaluated for hip analgesia. It is believed to provide pain relief for patients with hip fractures because it has multiple approaches. Cadaveric studies of the QLB showed direct dye spread to the roots and branches of the lumbar plexus; thus, these studies supported the possible benefit of QLB in hip surgeries. However, the anterior approach is being tried because the posterior and lateral approaches are not possible for these patients. The drug is deposited between the quadratus lumborum and the psoas muscle in this block, where it seeps up to the lumbar plexus. Therefore, we wish to assess the effectiveness of analgesia of anterior quadratus lumborum block for positioning patients with fracture acetabulum for spinal anesthesia.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 18.00 Year(s) 至 65.00 Year(s)（—）
- 性别
- All
入选标准
- •• Patients undergoing open reduction and internal fixation for fracture acetabulum • In age group of 18-65 years of both sexes.
- •• Patients belonging to American Society of Anaesthesiologists (ASA) class I, II and III.
- •• Patients giving consent for participation.
排除标准
- •• Patient should not be a part of any other study.
- •• Patients allergic to local anaesthetic(Ropivacaine) • Local pathology at the injection site.
- •• Patients with neurological, psychiatric, neuromuscular disease or patient not able to tell block assessment.
结局指标
主要结局
1. To assess and compare difference in NRS from baseline , 5 min , 30 min after the block.
时间窗: 1. To assess and compare difference in NRS from baseline at 5 min ,10min ,15 min,20 min, 25 min, 30 min after the block. | 2. To assess and compare Mean Time taken 5min to 30 min achieve NRS less then 2 for assessing sitting position for spinal anesthesia. | 3. To assess and compare the difference in sitting angle before the block and at positioning for spinal anesthesia.(NRS less then 2) | 4. To assess good positioning for CSE anesthesia in terms of number of pricks for successful lumbar puncture
2. To assess and compare Mean Time taken 5 min to 30 min achieve NRS less then 2 for assessing sitting position for spinal anesthesia.
时间窗: 1. To assess and compare difference in NRS from baseline at 5 min ,10min ,15 min,20 min, 25 min, 30 min after the block. | 2. To assess and compare Mean Time taken 5min to 30 min achieve NRS less then 2 for assessing sitting position for spinal anesthesia. | 3. To assess and compare the difference in sitting angle before the block and at positioning for spinal anesthesia.(NRS less then 2) | 4. To assess good positioning for CSE anesthesia in terms of number of pricks for successful lumbar puncture
3. To assess and compare the difference in sitting angle before the block and at positioning for spinal anesthesia.(NRS less then 2)
时间窗: 1. To assess and compare difference in NRS from baseline at 5 min ,10min ,15 min,20 min, 25 min, 30 min after the block. | 2. To assess and compare Mean Time taken 5min to 30 min achieve NRS less then 2 for assessing sitting position for spinal anesthesia. | 3. To assess and compare the difference in sitting angle before the block and at positioning for spinal anesthesia.(NRS less then 2) | 4. To assess good positioning for CSE anesthesia in terms of number of pricks for successful lumbar puncture
4. To assess good positioning for CSE anesthesia in terms of number of pricks for successful lumbar puncture
时间窗: 1. To assess and compare difference in NRS from baseline at 5 min ,10min ,15 min,20 min, 25 min, 30 min after the block. | 2. To assess and compare Mean Time taken 5min to 30 min achieve NRS less then 2 for assessing sitting position for spinal anesthesia. | 3. To assess and compare the difference in sitting angle before the block and at positioning for spinal anesthesia.(NRS less then 2) | 4. To assess good positioning for CSE anesthesia in terms of number of pricks for successful lumbar puncture
次要结局
- 1. To assess post-operative analgesia at 6,12,18,24 hours in cases of spinal anesthesia.
研究者
Dr Vandana Mangal
Sawai Man Singh Medical College, Jaipur