Determination Of Dispersion In Ultrasound Guided Quadratus Lumborum Block In Cadavers

NCT ID: NCT03545295

Last Updated: 2018-06-04

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 20 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-08-01
• Study Completion Date: 2019-05-31

Brief Summary

Lumbar Quadrant Blockade is a recent analgesic technique consisting of the injection of local anesthetic around the lumbar square muscle. It was initially described as a technique for abdominal wall analgesia, but later studies have increased the range of indications for laparoscopic and lower limb surgeries. There are several techniques described but with differences in the literature at the point of injection and volume of anesthetic. The exact mechanism of visceral analgesia has not yet been determined. The objective of this study is to determine the dispersion of local anesthetic as a variable dependent on the volume of local anesthetic and injection site and elucidate the mechanisms of analgesia.

Detailed Description

After the free and informed consent signed by the family authorizing the procedure, demographic and clinical data will be collected from the medical records of the deceased. The corpse will be weighed, measured and placed on the autopsy table. Blockade randomization (QLB 2 or QLB 3) and volume of local anesthetic (10ml, 20ml, 30ml) will be performed for each side. Injection in the anterior or posterior plane to the Lumbar Quadrant muscle will be performed by anesthesiologists experienced in the technique with ultrasound aid. A colouring solution will be used. After confirming the correct needle position, the previously randomized volumes will be injected. After the blockage, the corpse will be placed in the supine position and will be submitted to autopsy by standard procedure. After removal of the thoracic and abdominal viscera, the investigators will verify the dispersion of the local anesthetic. Photographic records will be made and the number of levels by which the solution dispersed will be annotated, calculating the number of cranial and caudal levels. The corpse will then have its autopsy procedure completed, with the placement of the viscera and incision closure according to the service standard.

Conditions

Nerve Block

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

QLB 2 10ml

The cadaver will receive an ultrasound- guided Quadratus Lumborum Block type 2 with 10 ml coloring solution

Group Type: EXPERIMENTAL

Quadratus Lumborum Block type 2

Intervention Type: PROCEDURE

Ultrasound guided injection of coloring solution using a 18g Tuohy echogenic needle, posterior to the Quadratus Lumborum muscle

QLB 2 20ml

The cadaver will receive an ultrasound- guided Quadratus Lumborum Block type 2 with 20 ml coloring solution

Group Type: EXPERIMENTAL

Quadratus Lumborum Block type 2

Intervention Type: PROCEDURE

Ultrasound guided injection of coloring solution using a 18g Tuohy echogenic needle, posterior to the Quadratus Lumborum muscle

QLB 2 30ml

The cadaver will receive an ultrasound- guided Quadratus Lumborum Block type 2 with 30 ml coloring solution

Group Type: EXPERIMENTAL

Quadratus Lumborum Block type 2

Intervention Type: PROCEDURE

Ultrasound guided injection of coloring solution using a 18g Tuohy echogenic needle, posterior to the Quadratus Lumborum muscle

QLB 3 10ml

The cadaver will receive an ultrasound- guided Quadratus Lumborum Block type 3 with 10 ml coloring solution

Group Type: EXPERIMENTAL

Quadratus Lumborum Block type 3

Intervention Type: PROCEDURE

Ultrasound guided injection of coloring solution using a 18g Tuohy echogenic needle, anterior to the Quadratus Lumborum muscle

QLB 3 20ml

The cadaver will receive an ultrasound- guided Quadratus Lumborum Block type 3 with 20 ml coloring solution

Group Type: EXPERIMENTAL

Quadratus Lumborum Block type 3

Intervention Type: PROCEDURE

Ultrasound guided injection of coloring solution using a 18g Tuohy echogenic needle, anterior to the Quadratus Lumborum muscle

QLB 3 30ml

The cadaver will receive an ultrasound- guided Quadratus Lumborum Block type 3 with 30 ml coloring solution

Group Type: EXPERIMENTAL

Quadratus Lumborum Block type 3

Intervention Type: PROCEDURE

Ultrasound guided injection of coloring solution using a 18g Tuohy echogenic needle, anterior to the Quadratus Lumborum muscle

Interventions

Quadratus Lumborum Block type 2

Ultrasound guided injection of coloring solution using a 18g Tuohy echogenic needle, posterior to the Quadratus Lumborum muscle

Intervention Type: PROCEDURE

Quadratus Lumborum Block type 3

Ultrasound guided injection of coloring solution using a 18g Tuohy echogenic needle, anterior to the Quadratus Lumborum muscle

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Fresh corpses - not subjected to a formaldehyde process or frozen for more than 24 hours
• Age ≥ 18 years.
• Free, informed and informed consent signed by relatives or guardians of the body.
• Height> 150 cm and <190 cm

Exclusion Criteria

• Previous spinal surgery.
• Significant spinal deformity
• Body mass index (BMI) ≥ 35 kg / m2
• Absence of relatives or guardians who can sign the written consent

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Irmandade da Santa Casa de Misericordia de Sao Paulo

OTHER

Sponsor Role: collaborator

Federal University of São Paulo

OTHER

Sponsor Role: lead

Responsible Party

Marcelo Vaz Perez

Médico Assistente

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Marilia Tassinari Gonçalves Preza, MD

Role: PRINCIPAL_INVESTIGATOR

Post Graduate

Locations

Irmandade de Misericórdia da Santa Casa De São Paulo

São Paulo, São Paulo, Brazil

Countries

Brazil

Central Contacts

Marcelo V Perez, PhD

Role: CONTACT

marcelovazperez@gmail.com

+551121767000

Facility Contacts

Marcelo V Perez, PhD

Role: primary

marcelovazperez@gmail.com

References

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Reference Type: BACKGROUND

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Reference Type: BACKGROUND

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Ueshima H, Otake H. RETRACTED: Lower limb amputations performed with anterior quadratus lumborum block and sciatic nerve block. J Clin Anesth. 2017 Feb;37:145. doi: 10.1016/j.jclinane.2016.12.026. Epub 2017 Jan 10. No abstract available.

Reference Type: BACKGROUND

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Other Identifiers

Quadratus Lumborum Block

Identifier Type: -

Identifier Source: org_study_id