Comparison of Two Techniques of Quadratus Lumborum Block

Nerve Block Clinical Trial

Official title:

Transverse Versus Longitudinal Technique of Ultrasound-Guided Transmuscular Quadratus Lumborum Block:A Randomized Controlled Study Comparing Dermatomal Spread

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05001802
• Other study ID #: 20210505
• Status: Recruiting
• Phase: N/A
• Start date: August 20, 2021
• Est. completion date: December 1, 2021

Study information

• Verified date: November 2021
• Source: Peking Union Medical College Hospital
• Contact: Xulei MD Cui
• Phone: +8613717739381
• Email: cuixulei10685[@]pumch.cn
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Our objective is to investigate the extent of cranial dermatomal spread of transmuscular quadratus lumborum block(TMQLB )when equal dosage(ml/kg) of local anesthetic are injected with the transverse versus an modified paramedian sagittal approach for patients undergoing laparoscopic adrenalectomy.

Description:

The paramedian sagittal oblique transmuscular quadratus lumborum block(TMQLB )approach has been introduced to facilitate cranial spread by injecting the local in a caudal to cranial direction compared with the transverse approach. Currently, there are no data comparing the two techniques mentioned above with regards to extent of spread level. Our objective is to investigate the extent of cranial dermatomal spread of TMQLB when equal dosage(ml/kg) of local anesthetic are injected with the transverse versus an modified paramedian sagittal approach for patients undergoing laparoscopic adrenalectomy. In addition, the investigators wish to compare the performance time, caudal dermatomal spread of TMQLB and postoperative analgesia effect.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 50
• Est. completion date: December 1, 2021
• Est. primary completion date: November 16, 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• =Age 18yrs

• American Society of Anesthesiologists physical status I-II

• Undergo laparoscopic adrenalectomy

• Informed consent

• Able to cooperate with study process

Exclusion Criteria:

• Allergy to local anesthetic and other medications used in the study

• Patient refusal or lack of informed consent

• Coexisting hematological disorder or with deranged coagulation parameters

• Pre-existing major organ dysfunction such as hepatic and renal failure

• History of previous renal surgery.

Related Conditions & MeSH terms

• Nerve Block

Intervention

Procedure:
• transverse scan, in-plane, posterior- anterior quadratus lumborum block
transverse scan, in-plane, posterior- anterior quadratus lumborum block The patients will receive the transmuscular quadratus lumborum block before surgery using the transverse scan, in-plain, posterior to anterior approach. 0.6ml/kg 0.375% ropivacaine is injected when the correct needle location is confirmed.
• paramedian sagittal longitudinal scan, in-plane, caudal-cranial quadratus lumborum block
The patients will receive the transmuscular quadratus lumborum block before surgery using the paramedic sagittal longitudinal scan, in-plain, caudal-cephalic approach.0.6ml/kg 0.375% ropivacaine is injected when the correct needle location is confirmed.

Locations

Country	Name	City	State
China	Peking Union Medical College Hospital	Beijing
China	Peking Union Medical College Hospital	Beijing

Sponsors (1)

Lead Sponsor	Collaborator
Peking Union Medical College Hospital

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Cephalic sensory dermatomal spread	The pinprick method at the midclavicular line was used to assess the extent of the dermatomal blockade, 20 minutes following the completion of the procedure by a person who was blinded to group allocation. The most cephalic dermatomal level that show a decreased pinprick sensation is recorded.A block failure was defined as the absence of any demonstrable sensory block 20 minutes after performance of the block.	20 minutes after block performance]
Secondary	Time to performance of procedure	Duration from needle insertion toward local anesthetic injection finished	Duration of procedure
Secondary	Total sensory dermatomal spread	The pinprick method at the midclavicular line was used to assess the extent of the dermatomal blockade, 20 minutes following the completion of the procedure by a person who was blinded to group allocation. The total number of dermatomal levels that show decreased pinprick sensation is recorded.A block failure was defined as the absence of any demonstrable sensory block 20 minutes after performance of the block.	20 minutes after block performance
Secondary	Incidence of complication	incidence of complication including bleeding, hematoma, infection at puncture site, local anesthetic poisoning, etc	Within 48 hours after surgery
Secondary	Caudal sensory dermatomal spread	The pinprick method at the midclavicular line was used to assess the extent of the dermatomal blockade, 20 minutes following the completion of the procedure by a person who was blinded to group allocation. The most caudal dermatomal level that show a decreased pinprick sensation is recorded.A block failure was defined as the absence of any demonstrable sensory block 20 minutes after performance of the block.	20 minutes after block performance
Secondary	rescue analgesics usage	NSAIDs or opioids used for pain relief and their dosage	At 0,12,24,48 hours after surgery