Ultrasound Guided Erector Spinae Block Versus Thoracic Para-vertebral Block Versus Quadratus Lamborum Block in Open Renal Surgeries

NCT ID: NCT05890248

Last Updated: 2023-06-08

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 48 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2023-02-01
• Study Completion Date: 2024-02-01

Brief Summary

Open renal surgeries are associated with substantial postoperative pain, pain relief in patients undergoing this procedure is usually provided either by thoracic epidural analgesia (EA) or by systemic analgesics. EA is a very useful option for the management of postoperative pain in patients undergoing abdominal surgeries, but the risks and contraindications linked to EA like hypotension, headache, nerve damage or infection may limit its use. Systemic analgesics in the form of opioid analgesics may give rise to side effects like nausea ,vomiting , constipation , allergy or drowsiness and often provide insufficient analgesia. Hence, other methods of postoperative pain management are desired. Sensory level target according to the incision site Flank (T9-T11) , Thoraco-abdominal (T7-T12 ) and Trans-abdominal (T6-T10). Ultrasound (US) guided erector spinae plane (ESP) block is one of the interfascial plane blocks that target the dorsal and ventral rami of the spinal nerves. Although there is no sufficient evidence for the spread of local anesthetic to the ventral rami, recent reports demonstrated effective postoperative analgesia after thoracic and lumbar surgeries affecting both the ventral and dorsal rami. Paravertebral block (PVB) is a technique where a local anesthetic is deposited into a space found on both sides of the spine, called the paravertebral space. It is a block with a dermatomal distribution of pain relief depending on the level of the spine at which the block is sited and the quantity and type of deposited local anesthetic.

PVB is effective for pain relief in the thoracic, abdominal and limb regions. primary aim was to compare postoperative opioid consumption rates at 24 h. Secondary end points were to compare pain scores and hemodynamic variables.

Detailed Description

This was randomized, controlled, single-blinded study, conducted in urology operating theatre, Al-Azhar university hospital. Forty eight patients of both sex and aged from 21-65 years in period between February 2022 to January 2023 scheduled for elective open renal surgeries under general anesthesia were enrolled in this study. The procedure was explained to the patient and informed consent was signed after his agreement then the patient was classified to one of three groups

Conditions

Renal Disease

Study Design

• Observational Model Type: CASE_CONTROL
• Study Time Perspective: PROSPECTIVE

Study Groups

Erector spinea block

-ESPB Group (n=12): Received erector spinae plane block.

Technique

Intervention Type: PROCEDURE

Paravertebral block versus Erector spinea block versus quadratus lamborum block

Thoracic Paravertebral block

TPVB Group (n=12) : Received thoracic paravertebral block.

Technique

Intervention Type: PROCEDURE

Paravertebral block versus Erector spinea block versus quadratus lamborum block

Control group

Control Group (n=12): Received morphine (0.1 mg/kg iv) before skin incision .

No interventions assigned to this group

QLB group

Quadratus lamborum block n=12

Technique

Intervention Type: PROCEDURE

Paravertebral block versus Erector spinea block versus quadratus lamborum block

Interventions

Technique

Paravertebral block versus Erector spinea block versus quadratus lamborum block

Intervention Type: PROCEDURE

Other Intervention Names

Paravertebral block versus Erector spinea block versus quadratus lamborum block

Eligibility Criteria

Exclusion Criteria

• Patient's refusal.
• Patients with ASA (III , IV) score.
• Coagulopathy to be cancelled if ( INR>1.4 , Platelets count <100x109 )
• Infection at the injection site.
• Allergy to local anesthetics.
• Patients receiving opioids for chronic analgesic therapy

• Minimum Eligible Age: 21 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

mohamed A Aboelsuod, MD

OTHER

Sponsor Role: lead

Responsible Party

mohamed A Aboelsuod, MD

assisstant professor

Responsibility Role: SPONSOR_INVESTIGATOR

Locations

Azhar University

Cairo, , Egypt

Site Status: RECRUITING

Countries

Egypt

Central Contacts

mohamed Aboelsuod, MD

Role: CONTACT

abosoad.mohamed2017@gmail.com

00201091945931 ext. 0402927133

Facility Contacts

abdelwahab AS MOHAMED, MD

Role: primary

ABDELWAHABSALEH@GAMIL.COM

0201017733543

Other Identifiers

Mohamed A Aboelsuod

Identifier Type: -

Identifier Source: org_study_id