Cesarean Section Clinical Trial
Official title:
Postoperative Analgesic Effects of Various Quadratus Lumborum Block Approaches Following Cesarean Section.
included patients were divided into 4 groups and each group received a mode of post cesarian section analgesia and pain was assessed by visual analogue scale at rest and movement. 1. st group epidural analgesia 2. nd group Quadratus lumborum type 2 3. rd group Quadratus lumborum type 3 4. th group Quadratus lumborum type (2+3)
Patients fulfilling the eligibility criteria were approached prior to delivery. The attending physician explained the nature of the study and all patients signed an informed consent then patients were divided in to four groups as follows (equal sample size in each group): the QLB type 2 (QL2 group), QLB type 3 (QL3 group), QLB type 2 +3 (QL2+3 group) and EA only group. A 16-gauge intravenous cannula pathway was established in the non-dominant hand or arm in the operation unit. All parturient with standard monitoring including electrocardiogram, pulse arterial oxygen saturation, respiratory rate and non-invasive blood pressure (NIBP) was performed combined with spinal and epidural anesthesia before C-section in the left lateral position and peripheral nerve block at the end of surgery by an experienced doctor (A.M.A). The epidural needle was inserted into the lumbar epidural space at the level of L2-3 intervertebral space. After finding the epidural space using loss of resistance to saline technique, the tip of a spinal needle passed through the epidural needle. To achieve a sensory block height to the level of the sixth thoracic dermatome, every parturient received intrathecal anesthesia of 0.75% bupivacaine (1.3-1.7 )mL. Then, the needle was withdrawn and then an epidural catheter was inserted through the epidural needle in case the failure of intrathecal anesthesia. All surgical treatments were performed successfully in the usual manner. Immediately after surgery, all subjects were transferred to the post-anesthesia care unit (PACU) and administered pre-determined analgesia, All parturient were lift in the supine position, tilting 45 degrees to the opposed side in order to place the low-frequency convex probe properly and see the sonography clearly. Bilateral QLB was performed using the atraumatic needle (22-G, 120-mm needle for peripheral nerve blocks) advanced in-plane under the guidance of an ultrasound machine. The ultrasonogram of the abdominal wall was displayed clearly through probe moving or tilting. Pillows helped to relieve the tension along the abdominal wall of parturient. The whole procedure was performed strictly according to clinical protocol. In this study, QL2 or QL3 were conducted through an anterolateral approach with the supine position as mentioned in (Sato et al, 2017). The ultrasound transducer was placed transversely on both flanks at the horizontal level of L2-3 and adjusted until the "Shamrock sign" formed of QL muscle, psoas major and erector spinae was visualized, with imaging depth set between 0 and 9.9 cm. Needles will be penetrated in an anterolateral to posteromedial direction. Local anesthetic will be injected posterior to QL muscle in QL2, while in QL3, it will be located between QL muscle and psoas major. QL2+3 block was conducted in the same plane with only one puncture on each side. QL2 and QL3 groups received 0.2% ropivacaine at 30 mL at the sites mentioned above in each side for a total of 60 mL. For QL2+3 group, they recieved 0.2% ropivacaine 15 mL at each point of injection with the needle inserting only once in each side. The solution was injected after negative aspiration to exclude vascular puncture. As for the EA group, we used a single bolus of 6 mL saline solution containing 9 mg ropivacaine (0.15%) and 2 mg morphine via the epidural catheter as postoperative analgesia, and meanwhile, they received a procedure like QL2, but only saline was injected as placebo. Epidural catheters were detached from all parturient after the procedure mentioned above. Parturient received a standard postoperative analgesic regime of regular oral paracetamol 1.0 g 6 hourly. ;
Status | Clinical Trial | Phase | |
---|---|---|---|
Terminated |
NCT03772886 -
Reducing Cesarean Delivery Rate in Obese Patients Using the Peanut Ball
|
N/A | |
Completed |
NCT03631329 -
Predictability of Preoperative Carotid Artery Corrected Flow Time for Hypotension After Spinal Anesthesia in Patients Undergoing Cesarean Section
|
||
Completed |
NCT03244540 -
Regional Analgesia After Cesarean Section
|
Phase 4 | |
Active, not recruiting |
NCT03760718 -
Chloroprocaine Lavage to Improve Outcomes Related to Operative Cesarean Delivery
|
Early Phase 1 | |
Active, not recruiting |
NCT04965779 -
The Effect of Abdominal Binder Use on Postpartum Pain, Bleeding, and Breastfeeding Success in Cesarean Delivery Women
|
N/A | |
Terminated |
NCT01687972 -
INSORB Versus Subcuticular Sutures at Cesarean Section
|
Phase 1 | |
Withdrawn |
NCT01211431 -
Post-cesarean Pain Control Via Continuous Infusion of Ropivacain et Diclogenac Into the Wound Versus Intathecal Morphine
|
Phase 4 | |
Completed |
NCT00991627 -
Different Approaches to Maternal Hypotension During Cesarean Section
|
Phase 4 | |
Completed |
NCT00987701 -
Perineuraxial Anesthesia Fluid Management and Infant Neurobehaviors
|
N/A | |
Completed |
NCT01049477 -
The Effects of Music Therapy on Women's Anxiety Before and During Cesarean Delivery
|
N/A | |
Terminated |
NCT00524511 -
Comparison Study of Wound Closure at Time of Cesarean Delivery: Dermabond Glue Versus Surgical Staples
|
N/A | |
Completed |
NCT00375986 -
A Comparison of Manual vs. Spontaneous Removal of the Placenta at Cesarean Section
|
N/A | |
Terminated |
NCT00386477 -
Vaginal Cleansing at Cesarean Delivery to Reduce Infection: A Randomized, Controlled Trial
|
N/A | |
Completed |
NCT00517140 -
Vaginal Birth After Caesarean Section - Effect on Maternal Psychosocial Function
|
N/A | |
Terminated |
NCT05051150 -
Epinephrine Infusion for Prophylaxis Against Maternal Hypotension During Caesarean Section
|
Phase 4 | |
Terminated |
NCT03695172 -
Comparison of TAP, Anterior QL, or ESP Block for Elective Cesarean Section
|
Phase 4 | |
Recruiting |
NCT06247852 -
Persistent Pain After Cesarean Delivery - A Danish Multicenter Cohort Study
|
||
Completed |
NCT06012747 -
Pain After Cesarean Section - A Danish Multicenter Cohort Study.
|
||
Not yet recruiting |
NCT05187520 -
Naldebain for Control of Post-Cesarean Section Pain
|
Phase 2 | |
Not yet recruiting |
NCT04999670 -
Fascial Closure and Post-caesarean Pain
|
N/A |