Comaprison Between QLB and ESPB in Patients for PCNL Operation

Pain, Postoperative Clinical Trial

Official title:

Comparison Between Ultrasound Guided Subcostal Oblique Quadratus Lumborum Block and Erector Spinae Plane Block in Patients Undergoing Percutaneous Nephrolithotomy

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04277611
• Other study ID #: QLB and ESPB comparison
• Status: Completed
• Phase: N/A
• Start date: April 20, 2021
• Est. completion date: June 30, 2022

Study information

• Verified date: September 2022
• Source: Assiut University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

comparing the subcostal oblique Quadratus Lumborum block and the Erector Spinae plane block in patients undergoing percutaneous nephrolithotomy operation to get the best and longest postoperative analgesic effect.

Description:

Here the investigators are going to compare between the Anterior approach for the subcostal oblique Quadratus Lumborum block (QLB) and the Erector Spinae Plane Block (ESPB) to determine their level of spread and their value in controlling postoperative pain in patients scheduled for Percutaneous Nephrolithotomy surgery. We hypothesized that quadratus lumborum is not inferior regarding the duration of analgesia when compared to erector spinae in patients undergoing percutaneous nephrolithotomy under general anesthesia.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 92
• Est. completion date: June 30, 2022
• Est. primary completion date: June 1, 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 60 Years

Eligibility

Inclusion Criteria:

• Both sex

• Age: 18-60

• ASA (American Society of Anesthesiologists) class I and II

• Elective surgery

• Patients undergoing PNL surgery

Exclusion Criteria:

• Patient's refusal

• Allergy or contraindications to drugs used in the study

• Emergency surgery

• Psychiatric disorders

• Severely co-morbid patients

• Inflammation or infection over injection site

• Bleeding diathesis; INR more than 1.5 and Platelet count less than 100,000/mm3

• Peripheral neuropathy

• Obese patients BMI =35

• Patients on previous opioid therapy

• Pre-operative haemoglobin <10 mg/dl

• Inability to properly describe postoperative pain to investigators

• Coagulation abnormalities

• History of drug addiction or alcohol abuse

• History of Previous renal surgery

Related Conditions & MeSH terms

• Pain, Postoperative

Intervention

Procedure:
• Subcostal Oblique Quadratus Lumborum Block and Erector Spinae Plain Block.
patients undergo general anesthesia,will be put in prone position.In case of Quadratus Lumborum block 1-3 mL of normal saline is injected to produce hydro-dissection and spread cranially between the QL and kidney. The corresponding ultrasonographic sign is a lunar-shaped hypo-echoic fluid collection observed between the long axis of the kidney and QL muscle. 20 ml Bupivacaine 0.5%, 10 ml Lidocaine 2%, and 10 ml normal saline is administered. In case of the ESPB The location of the needle tip is confirmed by hydro-dissection and after visualizing the fluid spread lifting the Erector Spinae off the transverse process, 20 ml bupivacaine 0.5%, 10 ml Lidocaine 2%, and 10 ml normal saline is injected.

Locations

Country	Name	City	State
Egypt	Assiut University Hospitals	Assiut

Sponsors (1)

Lead Sponsor	Collaborator
Assiut University

Country where clinical trial is conducted

Egypt, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Analgesia	Total opioid consumption during the first 48hours postoperatively.	48 hours
Secondary	Analgesia	first Analgesic request postoperatively.	24 hours
Secondary	episodes of nausea and vomiting	to investigate if there is or not.	within 24 hours postoperative
Secondary	Pain Scores using Visual Analog Scale (VAS) Scores	VAS is a scale to determine the patient's pain level.	24 hours postoperative.
Secondary	ambulation time	time from the end of the surgery to the first time to out-of-bed activity	5 days postoperative
Secondary	time of recovery of bowl movement	time from the end of the surgery to the first time of bowl movement	5 days postoperative
Secondary	patient satisfaction with anesthesia	Patient satisfaction with anesthesia was assessed using a 5-point scale (5: very satisfied; 4: satisfied; 3: neither satisfied nor dissatisfied; 2: dissatisfied; 1: very dissatisfied)	48 hours postoperative.
Secondary	postoperative length of hospital stay	till time of discharge	within 2 weeks postoperative.