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NCT Number: NCT04277611

Comaprison Between QLB and ESPB in Patients for PCNL Operation

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.

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Key information

Conditions

Pain, Postoperative Agnosia Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Pain Pathologic Processes Pathological Conditions, Signs and Symptoms Perceptual Disorders Postoperative Complications Signs and Symptoms

Age range

18 year–60 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Assiut University Hospitals

Asyut, 71111, Egypt

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Subcostal Oblique Quadratus Lumborum Block and Erector Spinae Plain Block.

Procedure

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.

Primary outcomes

  1. Analgesia

    Time frame: 48 hours

    Total opioid consumption during the first 48hours postoperatively.

Secondary outcomes

  1. Analgesia

    Time frame: 24 hours

    first Analgesic request postoperatively.

  2. episodes of nausea and vomiting

    Time frame: within 24 hours postoperative

    to investigate if there is or not.

  3. Pain Scores using Visual Analog Scale (VAS) Scores

    Time frame: 24 hours postoperative.

    VAS is a scale to determine the patient's pain level.

  4. ambulation time

    Time frame: 5 days postoperative

    time from the end of the surgery to the first time to out-of-bed activity

  5. time of recovery of bowl movement

    Time frame: 5 days postoperative

    time from the end of the surgery to the first time of bowl movement

  6. patient satisfaction with anesthesia

    Time frame: 48 hours postoperative.

    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)

  7. postoperative length of hospital stay

    Time frame: within 2 weeks postoperative.

    till time of discharge

Sponsors and collaborators

Lead sponsor

Assiut University

Other

Registry information

Official study title

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

Important dates

Study start
2021
Primary completion
2022
Study completion
2022
First posted
Feb 20, 2020
Registry last updated
Sep 7, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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