Quadratus Lumborum Block Type III Versus Type II Versus Transversus Abdominis Plane Block in Cesarean Section

NCT ID: NCT05950568

Last Updated: 2023-07-25

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

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-24

Study Completion Date

2023-06-25

Brief Summary

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Compare the type III and type II quadratus lumborum block (QLB) to transversus abdominis plane block (TAPB) regarding efficacy in CS

Detailed Description

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The transversus abdominis plane block (TAPB) is administered between the internal oblique muscle and the transversus abdominis muscle in the fascial plane, directly pointing to the somatic nerves T6-L1 that run in this plane. In addition, meta-analyses demonstrate that it is an effective analgesic for somatic pain and diminishes opiate intake. It has been reported that TAPB is an efficient analgesic approach following cesarean section .

The quadratus lumborum (QL) muscle block (QLB) is a fascial plane block as local anesthetic (LA) is introduced nearby to the QL muscle to numb the thoracolumbar nerves. QLB is categorized into four types according to drug administration location, I (lateral), II (posterior), III (anterior/transmuscular), and Intravenous, (intramuscular). QLB can effectively decrease both visceral and somatic pain by LA distribution to the thoracic paravertebral space (TPVS), as this block ensures effective pain control from the T7 to L1 dermatomes. QLB is one of the regional techniques that provides the greatest benefit in post-CS pain control, as it is progressively applied in obstetric anesthetic precise to improve analgesic results.

Conditions

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Cesarean Section Quadratus Lumborum Block Transversus Abdominis Plane Block

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Quadratus lumborum block type II

A 22 gauge needle was positioned between the erector spinae muscle in the thoracolumbar fascia's middle layer

Group Type ACTIVE_COMPARATOR

Quadratus lumborum block typen II

Intervention Type PROCEDURE

A 22 gauge needle was positioned between the quadratus lumborum muscle posterior border and the erector spinae muscle in the thoracolumbar fascia's middle layer

Quadratus lumborum block type III

A 22 gauge needle was positioned between the psoas and quadratus lumborum muscles at the anterior fascia lumbosacral

Group Type ACTIVE_COMPARATOR

Quadratus lumborum block III

Intervention Type PROCEDURE

A 22 gauge needle was positioned between the psoas and quadratus lumborum muscles at the anterior fascia lumbosacral

Transversus abdominis plane block

A 22 gauge needle was positioned between the internal oblique and transversus abdominis muscles

Group Type ACTIVE_COMPARATOR

Transversus abdominis plane block

Intervention Type PROCEDURE

A 22 gauge needle was positioned between the internal oblique and transversus abdominis muscles

Interventions

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Quadratus lumborum block typen II

A 22 gauge needle was positioned between the quadratus lumborum muscle posterior border and the erector spinae muscle in the thoracolumbar fascia's middle layer

Intervention Type PROCEDURE

Quadratus lumborum block III

A 22 gauge needle was positioned between the psoas and quadratus lumborum muscles at the anterior fascia lumbosacral

Intervention Type PROCEDURE

Transversus abdominis plane block

A 22 gauge needle was positioned between the internal oblique and transversus abdominis muscles

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* American Society of Anesthesiologists (ASA) physical status II
* aged 18 to 40 years old
* presenting for elective Cesarean section

Exclusion Criteria

* body mass index (BMI) ≥40 kg/m2
* weight \< 50kg
* height \< 150 cm
* contraindications for the use of active labor, spinal anesthesia
* recent opiate intake
* hypersensitivity to any used medication
* substantial cardiovascular diseases
* renal diseases
* hepatic, diseases.
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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The General Authority for Teaching Hospitals and Institutes

NETWORK

Sponsor Role lead

Responsible Party

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Abeer Ali Elshabacy

Consultant of obstetrics and gynecology

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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The General Authority for Teaching Hospitals and Institutes

Cairo, , Egypt

Site Status

Countries

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Egypt

Other Identifiers

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HB000132

Identifier Type: -

Identifier Source: org_study_id

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