Quadratus Lumborum Block vs Transversus Abdominis Plane Block for Post-prostatectomy Analgesia

NCT ID: NCT03606889

Last Updated: 2022-06-06

Basic Information

• Recruitment Status: TERMINATED
• Clinical Phase: NA
• Total Enrollment: 12 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-07-31
• Study Completion Date: 2021-12-31

Brief Summary

Recently, the uses of peripheral axial blocks that deliver local anesthetic into the transversus abdominis fascial plane have become popular for operations that involve incision(s) of the abdominal wall. Thus, the Transversus Abdominis plane (TAP) block has been shown to reduce perioperative opioid use in elective abdominal surgery, including open appendicectomy, laparotomy, and laparoscopic cholecystectomy.

Currently, the Quadratus Lumborum block (QL block) is performed as one of the perioperative pain management procedures for all generations (pediatrics, pregnant, and adult) undergoing abdominal surgery. The local anesthetic injected via the approach of the posterior QL block ( QL 2 block ) can more easily extend beyond the TAP to the thoracic paravertebral space or the thoracolumbar plane, the posterior QL block entails a broader sensory-level analgesic and may generate analgesia from T7 to L1. Use of posterior QL block in laparoscopic prostatectomy has not been investigated before and it is the variant that will be discussed in our study.

Detailed Description

In laparoscopic prostatectomy, overall pain is a conglomerate of three different and clinically separate components: incisional pain (somatic pain), visceral pain (deep intra abdominal pain), and shoulder pain due to peritoneal stretching and diaphragmatic irritation associated with carbon dioxide insufflation. Moreover, it has been hypothesized that intense acute pain after laparoscopic prostatectomy may predict development of chronic pain. Without effective treatment, this ongoing pain may delay recovery, mandate inpatient admission, and thereby increase the cost of such care.

Conditions

Prostatic Cancer; Pain, Postoperative; Pain; Anesthetics, Local

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: QUADRUPLE

Study Groups

Quadratus Lumborum block group

Quadratus Lumborum block group (QL) patients will receive a bilateral Quadratus Lumborum block using Bupivicaine 0.125%

Group Type: EXPERIMENTAL

Quadratus Lumborum block

Intervention Type: DIAGNOSTIC_TEST

0.2 ml/kg bupivicaine 0.125% injected bilateraly at the posterior border of the quadratus Lumborum muscle

Bupivacaine

Intervention Type: DRUG

0.2 ml/kg bupivicaine

Transversus abdominis plane block group

Transversus abdominis plane block (TAP) patients will receive a bilateral TAP block using Bupivicaine 0.125%

Group Type: EXPERIMENTAL

Tranversus Abdominis plane block

Intervention Type: DIAGNOSTIC_TEST

0.2 ml/kg bupivicaine 0.125% injected bilateraly between internal oblique and transversus abdominis muscles.

Bupivacaine

Intervention Type: DRUG

0.2 ml/kg bupivicaine

Interventions

Quadratus Lumborum block

0.2 ml/kg bupivicaine 0.125% injected bilateraly at the posterior border of the quadratus Lumborum muscle

Intervention Type: DIAGNOSTIC_TEST

Tranversus Abdominis plane block

0.2 ml/kg bupivicaine 0.125% injected bilateraly between internal oblique and transversus abdominis muscles.

Intervention Type: DIAGNOSTIC_TEST

Bupivacaine

0.2 ml/kg bupivicaine

Intervention Type: DRUG

Other Intervention Names

QLB; TAP

Eligibility Criteria

Inclusion Criteria

• Pateints who will have prostatectomy ASA II or III

Exclusion Criteria

-

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 90 Years
• Eligible Sex: MALE
• Accepts Healthy Volunteers: No

Sponsors

Jagiellonian University

OTHER

Sponsor Role: lead

Responsible Party

Tomasz Skladzien

MD PHD

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Tomasz Skladzien, MD PHD

Role: PRINCIPAL_INVESTIGATOR

Jagiellonian University

Locations

University Hospital in Cracow

Krakow, , Poland

Countries

Poland

Other Identifiers

1072.6120.107.2018

Identifier Type: -

Identifier Source: org_study_id