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Completed

NCT Number: NCT05950568

Quadratus Lumborum Block Type III Versus Type II Versus Transversus Abdominis Plane Block in Cesarean Section

Compare the type III and type II quadratus lumborum block (QLB) to transversus abdominis plane block (TAPB) regarding efficacy in CS

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Key information

Conditions

Cesarean Section Quadratus Lumborum Block Transversus Abdominis Plane Block

Age range

18 year–40 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

The General Authority for Teaching Hospitals and Institutes

Cairo, 11511, Egypt

About this study

The transversus abdominis plane block (TAPB) is administered between the internal oblique muscle and the transversus abdominis muscle in the fascial plane, directly pointing to the somatic nerves T6-L1 that run in this plane. In addition, meta-analyses demonstrate that it is an effective analgesic for somatic pain and diminishes opiate intake. It has been reported that TAPB is an efficient analgesic approach following cesarean section .

The quadratus lumborum (QL) muscle block (QLB) is a fascial plane block as local anesthetic (LA) is introduced nearby to the QL muscle to numb the thoracolumbar nerves. QLB is categorized into four types according to drug administration location, I (lateral), II (posterior), III (anterior/transmuscular), and Intravenous, (intramuscular). QLB can effectively decrease both visceral and somatic pain by LA distribution to the thoracic paravertebral space (TPVS), as this block ensures effective pain control from the T7 to L1 dermatomes. QLB is one of the regional techniques that provides the greatest benefit in post-CS pain control, as it is progressively applied in obstetric anesthetic precise to improve analgesic results.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • American Society of Anesthesiologists (ASA) physical status II
  • aged 18 to 40 years old
  • presenting for elective Cesarean section

Exclusion criteria

  • body mass index (BMI) ≥40 kg/m2
  • weight < 50kg
  • height < 150 cm
  • contraindications for the use of active labor, spinal anesthesia
  • recent opiate intake
  • hypersensitivity to any used medication
  • substantial cardiovascular diseases
  • renal diseases
  • hepatic, diseases.

Treatment and study plan

Quadratus lumborum block typen II

Procedure

A 22 gauge needle was positioned between the quadratus lumborum muscle posterior border and the erector spinae muscle in the thoracolumbar fascia's middle layer

Quadratus Lumborum Block III

Procedure

A 22 gauge needle was positioned between the psoas and quadratus lumborum muscles at the anterior fascia lumbosacral

transversus abdominis plane block

Procedure

A 22 gauge needle was positioned between the internal oblique and transversus abdominis muscles

Primary outcomes

  1. Total postoperative consumed pethidine

    Time frame: 24 hour postoperatively

    Numerical rating scales (NRS) score was evaluated at Post Anesthesia Care Unit (PACU), 2, 4, 6, 8, 12, 18, and 24 hours as as 0 is no pain and 10 is the worst pain imaginable. If the NRS score remained ≥ 4, we provided a bolus pethidine (0.5 mg/kg intravenous) and repeatable after 30 minutes if NRS remains≥ 4.

Secondary outcomes

  1. Time of the first analgesic request

    Time frame: 24 hour postoperatively

    If the Numerical rating scales (NRS) score remained ≥ 4, we provided a bolus pethidine (0.5 mg/kg intravenous).

  2. Patient satisfaction

    Time frame: 24 hour postoperatively

    The level of patient satisfaction was graded on a 5-point Likert scale as 0= extremely dissatisfied, 1= dissatisfied, 2= neither satisfied nor dissatisfied, 3= satisfied, 4= extremely satisfied

  3. The degree of postoperative pain

    Time frame: 24 hour postoperatively

    Numerical rating scales (NRS ) score was evaluated at Post Anesthesia Care Unit (PACU), 2, 4, 6, 8, 12, 18, and 24 hours as as 0 is no pain and 10 is the worst pain imaginable.

Sponsors and collaborators

Lead sponsor

The General Authority for Teaching Hospitals and Institutes

Network

Registry information

Official study title

Efficacy of Quadratus Lumborum Block Type III Versus Type II Versus Transversus Abdominis Plane Block in Cesarean Section: A Randomized Controlled Multicenter Trial

Important dates

Study start
2023
Primary completion
2023
Study completion
2023
First posted
Jul 18, 2023
Registry last updated
Jul 25, 2023

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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