Comparison of Quadratus Lumborum Intramuscular and Transmuscular in Postoperative Pain

Overview

Acute pain is reported in approximately 80% of patients undergoing postoperative care for various types of surgical procedures in the United States. Another study reported patient postoperative pain intensity with 75% with severe pain in the first 1 to 2 postoperative days and 38% reporting moderate to severe pain at 14 postoperative days. Several modalities have been used as the standard for the management of pain postoperative C-sections. One of the postoperative analgesic modalities for SC is quadratus lumborum block (QLB). This technique has advantages in relieving postoperative pain after C-section because it is considered to be able to relieve visceral pain as well as somatic pain. The transmuscular QLB (QLBT) approach is one of the most frequently used. This technique was found to be effective with regard to the distribution of analgesics to the paravertebral spaces which is the hallmark of QLB. However, this technique was found to be difficult to perform. Difficulties were reported related to the position of the procedure i.e. lateral or sitting position.

Full Title of Study: “Comparison of the Effectiveness of Intramuscular and Transmucular Quadratus Lumborum Blocks Quality in Postoperative Pain”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Double (Participant, Outcomes Assessor)
  • Study Primary Completion Date: September 30, 2021

Interventions

  • Other: Quadratus lumborum block after C-section surgery as postoperative pain management
    • To manage postoperative pain, the subjects will be allocated to either QLB or QLTB group to receive the respective intervention.

Arms, Groups and Cohorts

  • Active Comparator: Quadratus lumborum intramuscular block
    • The quadratus lumborum intramuscular block will be performed immediately at the end of the surgery. Administration of 0.4 mL of 0.25% bupivacaine will be carried out under ultrasound guidance and performed by experienced anesthesiologists.
  • Active Comparator: Quadratus lumborum transmucular block
    • The quadratus lumborum transmuscular block will be performed immediately at the end of the surgery. Administration of 0.4 mL of 0.25% bupivacaine will be carried out under ultrasound guidance and performed by experienced anesthesiologists.

Clinical Trial Outcome Measures

Primary Measures

  • Postoperative pain
    • Time Frame: Up to 24 hours after surgery
    • Postoperative pain intensity measured by Visual Analog Scale (VAS), 0=no pain, 100=worst pain
  • Postoperative morphine requirements
    • Time Frame: Up to 72 hours after surgery
    • Total delivered morphine dose after surgery to alleviate postoperative pain (measured by total delivered dose recorded on the Patient-Controlled Analgesia tool)

Participating in This Clinical Trial

Inclusion Criteria

  • Underwent C-section with subarachnoid block – Aged 18-35 years old. – ASA preoperative physical status 1-2 Exclusion Criteria:

  • Coagulopathy – Anatomic abnormalities of the abdomen – History of allergy to local anesthesia – History of hyperalgesia – History of drug abuse (sedatives, opioids, paracetamol, or other pain relievers) – Require postoperative intensive care – Refuse to participate in research.

Gender Eligibility: Female

Minimum Age: 18 Years

Maximum Age: 35 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Udayana University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Christopher Ryalino, MD, Principal Investigator – Udayana University

Clinical trials entries are delivered from the US National Institutes of Health and are not reviewed separately by this site. Please see the identifier information above for retrieving further details from the government database.

At TrialBulletin.com, we keep tabs on over 200,000 clinical trials in the US and abroad, using medical data supplied directly by the US National Institutes of Health. Please see the About and Contact page for details.