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NCT Number: NCT03771742

Modified Paramedic Sagittal vs. Transverse TMQLB

The classical transmuscular qudratus lumborum block(TMQLB) described by Borglum aims to provide lower thoracic paravertebral space(PVS) and sympathetic blockade by injecting local anesthetics between QL and PM muscle at the L3-L4 vertebral level using a transverse scan, posterior-anterior, in-plane approach. Recently, a paramedian sagittal oblique(TMQLB) approach has been introduced to facilitate cranial spread by injecting the local in a caudal to cranial direction. Currently, there are no data comparing the two techniques mentioned above with regards to extent of spread for PVS. 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.

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Key information

Conditions

Nerve Block

Age range

18 year–70 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Peking Union Medical College Hospital

Beijing, China

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Age 18-70 yrs
  • American Society of Anesthesiologists physical statusⅠ-Ⅲ
  • 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.

Treatment and study plan

transverse scan, in-plane, posterior-anterior TMQLB

Procedure

The patients will receive the transmuscular quadratus lumborum block(TMQLB) before surgery using the transverse scan, in-plain, posterior to anterior approach. 0.6ml/kg 0.375% ropivocaine is injected when the correct needle location is confirmed.

paramedian sagittal scan, in-plane, caudal-cranial TMQLB

Procedure

The patients will receive the transmuscular quadratus lumborum block(TMQLB) before surgery using the paramedic sagittal scan, in-plain, caudal-cephalic approach.0.6ml/kg 0.375% ropivocaine is injected when the correct needle location is confirmed.

Primary outcomes

  1. Cephalic sensory dermatomal spread

    Time frame: 20 minutes after block performance

Secondary outcomes

  1. Time to performance of procedure

    Time frame: Duration of procedure

  2. Total sensory dermatomal spread

    Time frame: 20 minutes after block performance

  3. Incidence of complication

    Time frame: Within 48hours after surgery

  4. Caudal sensory dermatomal spread

    Time frame: 20 minutes after block performance

  5. cumulative rate of rescue analgesics usage

    Time frame: At 0,2,4,8,12,24,48 hours after surgery

  6. NRS pain scores

    Time frame: At 0,2,4,8,12,24,48hours after surgery

    patients will evaluate their pain intensity with the numerical rating scale (NRS), where 0 indicates no pain, and 10 indicates the most severe pain.

Sponsors and collaborators

Lead sponsor

Peking Union Medical College Hospital

Other

Registry information

Official study title

Randomized Prospective Study to Evaluate Cranial Dermatomal Spread of Modified Paramedic Sagittal Versus Transverse Approach TMQLB for Adrenal Surgery

Important dates

Study start
2018
Primary completion
2019
Study completion
2019
First posted
Dec 11, 2018
Registry last updated
Apr 16, 2019

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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