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

Cesarean Section Clinical Trial

Official title:

Efficacy of Quadratus Lumborum Block Type III Versus Type II Versus Transversus Abdominis Plane Block in Cesarean Section: A Randomized Controlled Multicenter Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05950568
• Other study ID #: HB000132
• Status: Completed
• Phase: N/A
• Start date: March 24, 2023
• Est. completion date: June 25, 2023

Study information

• Verified date: July 2023
• Source: The General Authority for Teaching Hospitals and Institutes
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

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

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 60
• Est. completion date: June 25, 2023
• Est. primary completion date: June 25, 2023
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 18 Years to 40 Years

Eligibility

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.

Related Conditions & MeSH terms

• Cesarean Section
• Quadratus Lumborum Block
• Transversus Abdominis Plane Block

Intervention

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

Locations

Country	Name	City	State
Egypt	The General Authority for Teaching Hospitals and Institutes	Cairo

Sponsors (1)

Lead Sponsor	Collaborator
The General Authority for Teaching Hospitals and Institutes

Country where clinical trial is conducted

Egypt, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Total postoperative consumed pethidine	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.	24 hour postoperatively
Secondary	Time of the first analgesic request	If the Numerical rating scales (NRS) score remained = 4, we provided a bolus pethidine (0.5 mg/kg intravenous).	24 hour postoperatively
Secondary	Patient satisfaction	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	24 hour postoperatively
Secondary	The degree of postoperative pain	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.	24 hour postoperatively