TAPB vs QLBII for Kidney Transplantation Procedure

NCT ID: NCT02783586

Last Updated: 2018-05-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

104 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-04-08

Study Completion Date

2017-05-30

Brief Summary

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The main advantage of Quadratus Lumborum Block (QLB) compared to Transversus Abdominalis Plane Block (TAPB) is the impact on visceral pain due to the spread of the local anaesthetic agent to the paravertebral space. It may produce extensive analgesia and better pain control.

Previews studies shoved the effectiveness of TAPB in kidney transplantation procedure (KTX) by reducing opioids requirements during and after the operation. QLB was not evaluating in KTX procedure yet, but it reduced postoperative morphine requirement after cesarean section under spinal anaesthesia.

The aim of this prospective, randomised controlled, multicenter, clinical study is to compare the perioperative analgesic efficacy of QLB and TAPB in patients who had KTX under balanced (general and regional) anaesthesia.

Detailed Description

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After Bioethical Committee of Medical University of Warsaw approval, informed written consent will be obtained from all patients.

A sample size of 104 patients was calculated to obtain at list 25% reduction of fentanyl usage in QLBII group with 0,05% significance and power of 0,8. Consenting patients, scheduled to KTX procedure under general anaesthesia will be randomly assigned (1:1) according to the computer -generated randomization list with permuted blocks (block sizes: 20, 20, 24, 40) to receive 20ml of 0,25% Bupivacaine with epinephrine ipsilaterally to the operation side in QLBII or TAPB after the general anaesthesia induction and before the surgery starts. All the blocks will be performed in the supine patients position, under ultrasound guidance for both techniques. The correct spread of injectate will be confirmed with ultrasound.

Conditions

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Postoperative Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Quadratus Lumborum Block type II

Unilateral ultrasound guidance QLB on the operated side after induction of general anaesthesia - 20 ml of 0,25%bupivacaine with adrenaline injected with ultraplex needle

Group Type EXPERIMENTAL

Quadratus Lumborum Block type II

Intervention Type PROCEDURE

Local anaesthetic injection on the posterior border of the quadratus lumborum muscle

Bupivacaine

Intervention Type DRUG

20 ml of bupivacaine with adrenaline

Ultraplex

Intervention Type DEVICE

A non-stimulating echogenic single-shot needle designed for regional analgesia under ultrasound guidance.

Transversus Abdominalis Plane Block

Unilateral ultrasound guidance TAPB on the operated side after induction of general anaesthesia - 20 ml of 0,25% bupivacaine with adrenaline injected with ultraplex needle

Group Type ACTIVE_COMPARATOR

Transversus Abdominalis Plane Block

Intervention Type PROCEDURE

Local anaesthetic injection between internal oblique and transversus abdominis muscle

Bupivacaine

Intervention Type DRUG

20 ml of bupivacaine with adrenaline

Ultraplex

Intervention Type DEVICE

A non-stimulating echogenic single-shot needle designed for regional analgesia under ultrasound guidance.

Interventions

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Quadratus Lumborum Block type II

Local anaesthetic injection on the posterior border of the quadratus lumborum muscle

Intervention Type PROCEDURE

Transversus Abdominalis Plane Block

Local anaesthetic injection between internal oblique and transversus abdominis muscle

Intervention Type PROCEDURE

Bupivacaine

20 ml of bupivacaine with adrenaline

Intervention Type DRUG

Ultraplex

A non-stimulating echogenic single-shot needle designed for regional analgesia under ultrasound guidance.

Intervention Type DEVICE

Other Intervention Names

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Marcaine

Eligibility Criteria

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Inclusion Criteria

1. Kidney transplantation procedure with anatomical urinary outlet
2. Written informed consent

Exclusion Criteria

1. Patients' refusal
2. Known allergies to study medication
3. Inability to comprehend or participate in pain scoring scale
4. Inability to use intravenous patient controlled analgesia system
5. Anatomic, posttraumatic and postoperative deformations could possibly affect the spread of local anesthetic in transversus abdominalis plane or quadratus lumborum muscle plane.
6. Transversus abdominalis plane or quadratus lumborum muscle plane not seen in ultrasound examination.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University of Warsaw

OTHER

Sponsor Role lead

Responsible Party

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Marcin Kołacz

MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marcin Kolacz, MD,PhD

Role: STUDY_DIRECTOR

Medical University of Warsaw

Marcin Mieszkowski, MD

Role: PRINCIPAL_INVESTIGATOR

Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Poland

Locations

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I Department of Anaesthesiology and Intensive Care, Medical University of Warsaw

Warsaw, , Poland

Site Status

Countries

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Poland

References

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Kolacz M, Mieszkowski M, Janiak M, Zagorski K, Byszewska B, Weryk-Dysko M, Onichimowski D, Trzebicki J. Transversus abdominis plane block versus quadratus lumborum block type 2 for analgesia in renal transplantation: A randomised trial. Eur J Anaesthesiol. 2020 Sep;37(9):773-789. doi: 10.1097/EJA.0000000000001193.

Reference Type DERIVED
PMID: 32175985 (View on PubMed)

Other Identifiers

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TAPB/QLB-WAW/OLS

Identifier Type: -

Identifier Source: org_study_id

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