A Novel Approach for Transmuscular Quadratus Lumborum Block

Transmuscular Quadratus Lumborum Block Hip Surgery Clinical Trial

Official title:

A Novel Approach for Transmuscular Quadratus Lumborum Block for Peri-operative Analgesia in Hip Surgery

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03733769
• Other study ID #: TQL block in hip surgery
• Status: Completed
• Phase: N/A
• Start date: November 6, 2018
• Est. completion date: January 15, 2019

Study information

• Verified date: January 2019
• Source: Alexandria University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

a novel approach for TQL (anterior Q.L) block aiming mainly for terminal branches of lumbar plexus. The technique is described as Para-Spinous Saggital Shift Q.L block, done at L4 transverse process level in saggital orientation.

Description:

With this approach, we think it has advantages of easy identification, better caudal LA spread till under fascia iliaca, with the psoas major muscle provides a better protective barrier against accidental needle entry into the peritoneal cavity, the endpoint is injection within a fascial plane, rather than a specific motor response contact where the lumbar plexus stimulation is not sought, so there is minimal risk of nerve injury, inadvertent dural cuff puncture and intrathecal spread of local anesthetic. And finally optimal insertion of catheter in long axis of Q.L and psoas major if continuous analgesia is planned.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 4
• Est. completion date: January 15, 2019
• Est. primary completion date: January 15, 2019
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 70 Years

Eligibility

Inclusion Criteria:

• Orthopaedic patients, American Society of Anesthesiologists (ASA) physical status I-III, scheduled to undergo unilateral hip surgery.

Exclusion Criteria:

• History of neurological/neuromuscular, psychiatric disease, dementia preventing proper comprehension.

• Patients with Body Mass Index (BMI) <18.5 or >30 kg/m2.

• Coagulation disturbances (INR>1.4, platelet count<100 000).

• History of opioid dependence (opioid use within the last 4 weeks).

• History of allergies to study medications.

Related Conditions & MeSH terms

• Transmuscular Quadratus Lumborum Block Hip Surgery

Intervention

Procedure:
• transmuscular quadratus lumborum block
transmuscular quadratus lumborum block as an alternative to lumbar plexus block for peri-operative analgesia in hip Surgery

Locations

Country	Name	City	State
Egypt	Alexandria Faculty of Medicine	Alexandria

Sponsors (1)

Lead Sponsor	Collaborator
Alexandria University

Country where clinical trial is conducted

Egypt, 

References & Publications (3)

Adhikary SD, El-Boghdadly K, Nasralah Z, Sarwani N, Nixon AM, Chin KJ. A radiologic and anatomic assessment of injectate spread following transmuscular quadratus lumborum block in cadavers. Anaesthesia. 2017 Jan;72(1):73-79. doi: 10.1111/anae.13647. Epub 2016 Oct 12. — View Citation

Adhikary SD, Short AJ, El-Boghdadly K, Abdelmalak MJ, Chin KJ. Transmuscular quadratus lumborum versus lumbar plexus block for total hip arthroplasty: A retrospective propensity score matched cohort study. J Anaesthesiol Clin Pharmacol. 2018 Jul-Sep;34(3):372-378. doi: 10.4103/joacp.JOACP_335_17. — View Citation

Carline L, McLeod GA, Lamb C. A cadaver study comparing spread of dye and nerve involvement after three different quadratus lumborum blocks. Br J Anaesth. 2016 Sep;117(3):387-94. doi: 10.1093/bja/aew224. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	peri-operative analgesia in hip Surgery	post-operative VAS score	one month