TAP vs QLB in Patients After Cesarean Delivery

NCT ID: NCT03404908

Last Updated: 2023-11-24

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

105 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-02-07

Study Completion Date

2019-04-17

Brief Summary

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Comparison of two types of analgesia after cesarean section All patients will be anesthetized with spinal technique. Ultrasound-guided transversus abdominis plane or quadratus lumborum block to treat postoperative pain. Postoperative pain will be measured with visual-analog scale (VAS). 1, 2, 6 months after surgery each patient will be called to assess neuropathic pain with Neuropathic Pain Symptom Inventory (NPSI).

Detailed Description

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Written consent will be obtained before the cesarean section. Only subarachnoidally anesthetized patients may participate in the study. Pencil-point spinal needle and bupivacaine (Marcaine Heavy Spinal 0.5 %) will be used.

At the end of surgery ultrasound-guided regional block will be performed. Each patient will be randomly allocated to one of the treated group: transversus abdominis plane block (TAP) or quadratus lumborum (QL). Patients receive 0.2 mL of local anesthetic solution (0.375 % ropivacaine) on each side.

Postoperative pain will be measured with VAS (visual-analog scale) 2, 4, 8, 12 and 24 hours after the end of the operation.

Paracetamol, metamizole, ketoprofen may be given as required. Whenever pain exceeds 40 (VAS) 5 mg of morphine will be given intravenously (maximum two dosages per day).

1, 3, 6 months patients will be called to assess neuropathic pain. Neuropathic Pain Symptom Inventory (NPSI) will be used.

Conditions

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Cesarean Section Postoperative Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Parallel Assignment
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
Single (Participant)

Study Groups

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TAP

Ultrasound-guided transversus abdominis plane block at the end of cesarean section

Group Type EXPERIMENTAL

TAP (transversus abdominis plane block)

Intervention Type PROCEDURE

the ultrasound-guided regional block of abdominal wall muscles to treat acute postoperative pain. Stimuplex Ultra 360 needle will be used and 0.375% ropivacaine administered (0.2 mL/kg).

Ropivacaine

Intervention Type DRUG

In both groups (TAP\&QLB) 0.375% ropivacaine will be given (0.2 mL/kg)

Needle

Intervention Type DEVICE

Ultrasound-guided, Stimuplex ultra 360 needle will be used in the study

paracetamol

Intervention Type DRUG

Intravenous paracetamol will be used (1.0 gram), up to 4 grams per day

metamizole

Intervention Type DRUG

Intravenous metamizole will be used (1.0 gram), up to 4 grams per day

Ketoprofen

Intervention Type DRUG

Intravenous ketoprofen will be used (0.1 gram), up to 200 milligrams per day

Morphine

Intervention Type DRUG

Intravenous morphine (5 mg) will be given when pain exceeds 40 mm in VAS (maximum 2 doses per day)

QLB

Ultrasound-guided quadratus lumborum block at the end of cesarean section

Group Type EXPERIMENTAL

QL (quadratus lumborum block)

Intervention Type PROCEDURE

the ultrasound-guided regional block of abdominal wall muscles to treat acute pain, similar to transversus abdominis plane block, but with a distribution of local anesthetic towards paravertebral space. Stimuplex Ultra 360 needle will be used and 0.25% bupivacaine administered (0.2 mL/kg).

Ropivacaine

Intervention Type DRUG

In both groups (TAP\&QLB) 0.375% ropivacaine will be given (0.2 mL/kg)

Needle

Intervention Type DEVICE

Ultrasound-guided, Stimuplex ultra 360 needle will be used in the study

paracetamol

Intervention Type DRUG

Intravenous paracetamol will be used (1.0 gram), up to 4 grams per day

metamizole

Intervention Type DRUG

Intravenous metamizole will be used (1.0 gram), up to 4 grams per day

Ketoprofen

Intervention Type DRUG

Intravenous ketoprofen will be used (0.1 gram), up to 200 milligrams per day

Morphine

Intervention Type DRUG

Intravenous morphine (5 mg) will be given when pain exceeds 40 mm in VAS (maximum 2 doses per day)

Interventions

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TAP (transversus abdominis plane block)

the ultrasound-guided regional block of abdominal wall muscles to treat acute postoperative pain. Stimuplex Ultra 360 needle will be used and 0.375% ropivacaine administered (0.2 mL/kg).

Intervention Type PROCEDURE

QL (quadratus lumborum block)

the ultrasound-guided regional block of abdominal wall muscles to treat acute pain, similar to transversus abdominis plane block, but with a distribution of local anesthetic towards paravertebral space. Stimuplex Ultra 360 needle will be used and 0.25% bupivacaine administered (0.2 mL/kg).

Intervention Type PROCEDURE

Ropivacaine

In both groups (TAP\&QLB) 0.375% ropivacaine will be given (0.2 mL/kg)

Intervention Type DRUG

Needle

Ultrasound-guided, Stimuplex ultra 360 needle will be used in the study

Intervention Type DEVICE

paracetamol

Intravenous paracetamol will be used (1.0 gram), up to 4 grams per day

Intervention Type DRUG

metamizole

Intravenous metamizole will be used (1.0 gram), up to 4 grams per day

Intervention Type DRUG

Ketoprofen

Intravenous ketoprofen will be used (0.1 gram), up to 200 milligrams per day

Intervention Type DRUG

Morphine

Intravenous morphine (5 mg) will be given when pain exceeds 40 mm in VAS (maximum 2 doses per day)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* obtained consent
* singleton pregnancy
* subarachnoid anesthesia

Exclusion Criteria

* coagulopathy
* allergy to local anesthetics
* depression, antidepressant drugs treatment
* epilepsy
* usage of painkiller before surgery
* addiction to alcohol or recreational drugs
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Medical University of Lublin

OTHER

Sponsor Role lead

Responsible Party

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Michał Borys

associate professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mirosław Czuczwar, M.D., PhD

Role: STUDY_CHAIR

Medical University of Lublin

Locations

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II Department of Anesthesia and Intensive Care, Medical University of Lublin

Lublin, , Poland

Site Status

Countries

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Poland

Other Identifiers

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KE-0254/238/2017

Identifier Type: -

Identifier Source: org_study_id