Ultrasound Guided Quadratus Lumborum Block for Postoperative Pain in Abdominoplasty

NCT ID: NCT02932930

Last Updated: 2019-12-13

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

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-10-31

Study Completion Date

2019-08-31

Brief Summary

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The original concept of a quadratus lumborum block (QLB) indicated for analgesia after abdominal surgery was first described by Blanco in 2007. Also referred to as a posterior transversus abdominis plane (TAP) block, the QLB consists in deposition of local anesthetic on either the posterior or the anterolateral border of the quadratus lumborum muscle. TAP blocks have already been proved effective in urologic, abdominal, and gynecologic procedures by blocking the sensory nerve supply to the anterior abdominal wall thus reducing the amount of postoperative analgesic medication. The main advantages of QLB compared to the TAP block is a wider sensory block area and a longer duration of analgesia. This is due to the extension of local anesthetic agents beyond the TAP plane to the thoracic paravertebral space(4).

Previous reports have shown that QLB is effective in providing pain relief after various abdominal operations. However, there are no published reports on QLB for postoperative pain after abdominoplasty. This prospective, randomized, double-blinded, controlled study aims to evaluate the analgesic efficacy, opioids consumption and quality of recovery of QLB in patients undergoing abdominoplasty. Patients scheduled to have abdominoplasty will be randomized to receive bilateral QLB with either ropivacaine 0.2% or normal saline. Post-operative cumulative analgesic medication consumption, pain severity at rest and on movement, as well as quality of recovery will be evaluated and compared in both groups.

Detailed Description

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Conditions

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Pain

Keywords

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QLB Abdominoplasty Quadratus lumborum block

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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QLB group

Patients will receive at the beginning of the surgery 0.2 ml/kg of 0.2% ropivacaine bilaterally.

Procedure: Quadratus Lumborum Block type II, local anesthetic injection on the posterior border of the quadratus lumborum muscle Drug: Ropivacaine, 0.2 ml/kg of 0.2% ropivacaine

Group Type ACTIVE_COMPARATOR

QLB bloc

Intervention Type PROCEDURE

0.2% Ropivacaine

Intervention Type DRUG

0,2ml/kg of 0,2% ropivacaine

Control group

Patients will receive at the beginning of the surgery 0.2 ml/kg of 0.9% normal saline bilaterally.

Procedure: Quadratus Lumborum Block type II, local anesthetic injection on the posterior border of the quadratus lumborum muscle Drug: Normal saline, 0.2 ml/kg of 0.9 % normal saline

Group Type PLACEBO_COMPARATOR

QLB bloc

Intervention Type PROCEDURE

0.9% normal saline

Intervention Type DRUG

0,2ml/kg of 0.9% normal saline

Interventions

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QLB bloc

Intervention Type PROCEDURE

0.2% Ropivacaine

0,2ml/kg of 0,2% ropivacaine

Intervention Type DRUG

0.9% normal saline

0,2ml/kg of 0.9% normal saline

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Standard abdominoplasty procedure
2. Written informed consent
3. Age ≥ 18 years
4. Female

Exclusion Criteria

1. Patient's refusal
2. Allergies to any study medication
3. Inability to comprehend or participate in scoring scales
4. Deformations that could possibly affect the spread of the local anesthetic in the quadratus lumborum muscle plane
5. Quadratus lumborum muscle plane not seen in ultrasound examination
6. Coagulopathy or on anticoagulants
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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St Joseph University, Beirut, Lebanon

OTHER

Sponsor Role lead

Responsible Party

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samer jabbour

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Hotel Dieu De France

Beirut, Aschrafieh, Lebanon

Site Status

Countries

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Lebanon

References

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El-Boghdadly K, Elsharkawy H, Short A, Chin KJ. Quadratus Lumborum Block Nomenclature and Anatomical Considerations. Reg Anesth Pain Med. 2016 Jul-Aug;41(4):548-9. doi: 10.1097/AAP.0000000000000411. No abstract available.

Reference Type BACKGROUND
PMID: 27315184 (View on PubMed)

Hockett MM, Hembrador S, Lee A. Continuous Quadratus Lumborum Block for Postoperative Pain in Total Hip Arthroplasty: A Case Report. A A Case Rep. 2016 Sep 15;7(6):129-31. doi: 10.1213/XAA.0000000000000363.

Reference Type BACKGROUND
PMID: 27513972 (View on PubMed)

Sforza M, Andjelkov K, Zaccheddu R, Nagi H, Colic M. Transversus abdominis plane block anesthesia in abdominoplasties. Plast Reconstr Surg. 2011 Aug;128(2):529-535. doi: 10.1097/PRS.0b013e31821e6f51.

Reference Type BACKGROUND
PMID: 21788846 (View on PubMed)

Murouchi T, Iwasaki S, Yamakage M. Quadratus Lumborum Block: Analgesic Effects and Chronological Ropivacaine Concentrations After Laparoscopic Surgery. Reg Anesth Pain Med. 2016 Mar-Apr;41(2):146-50. doi: 10.1097/AAP.0000000000000349.

Reference Type BACKGROUND
PMID: 26735154 (View on PubMed)

Baidya DK, Maitra S, Arora MK, Agarwal A. Quadratus lumborum block: an effective method of perioperative analgesia in children undergoing pyeloplasty. J Clin Anesth. 2015 Dec;27(8):694-6. doi: 10.1016/j.jclinane.2015.05.006. Epub 2015 Jul 11. No abstract available.

Reference Type BACKGROUND
PMID: 26174113 (View on PubMed)

Blanco R, Ansari T, Girgis E. Quadratus lumborum block for postoperative pain after caesarean section: A randomised controlled trial. Eur J Anaesthesiol. 2015 Nov;32(11):812-8. doi: 10.1097/EJA.0000000000000299.

Reference Type BACKGROUND
PMID: 26225500 (View on PubMed)

Chakraborty A, Goswami J, Patro V. Ultrasound-guided continuous quadratus lumborum block for postoperative analgesia in a pediatric patient. A A Case Rep. 2015 Feb 1;4(3):34-6. doi: 10.1213/XAA.0000000000000090.

Reference Type BACKGROUND
PMID: 25642956 (View on PubMed)

Other Identifiers

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USJ-02

Identifier Type: -

Identifier Source: org_study_id