Ultrasound Guided QLB Versus Laparoscopic Superior Hypogastric Plexus Block for Postoperative Analgesia After Laparoscopic Hysterectomy

NCT ID: NCT06359743

Last Updated: 2024-04-11

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 34 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-04-01
• Study Completion Date: 2024-09-01

Brief Summary

Pain following laparoscopic hysterectomy may interfere with early ambulation, discharge of patient from hospital and interfere with enhanced recovery with more opioid consumption. Most of methods for postoperative pain depend on the use of high doses of opioids with more side effects such as nausea, vomiting, respiratory center depression, delay bowel motility and hemodynamics instability. To decrease of opioid consumption in postoperative pain management as well as related side effects, previous studies showed that quadratus lumborum block or superior hypogastric plexus block (SHPB) had shown promising success in management of postoperative pain in patients undergoing laparoscopic hysterectomy. The present study will be conducted to compare of ultrasound guided QL block and laparoscopic superior hypogastric plexus block as a part of multimodal analgesia may allow adequate analgesia and decrease the overall use of opioids and allow patient enhanced recovery.

Detailed Description

hypothesis: There is no difference between the analgesic effect of either Ultrasound guided QL block or laparoscopic Superior hypogastric plexus block on post laparoscopic hysterectomy pain.

Alternative hypothesis:

There is difference between the analgesic effect of either Ultrasound QL block or laparoscopic superior hypogastric plexus block on post laparoscopic hysterectomy pain.

Aim of the work Better achievement of effective analgesia with less opioid consumption and related side effects for post laparoscopic hysterectomy pain.

Objectives To assess effect of both ultrasound quadratus lumborum block and laparoscopic superior hypogastric plexus block on analgesic outcome (Visual Analogue Scale VAS, duration of analgesia) after laparoscopic hysterectomy. To compare between ultrasound quadratus lumborum block and laparoscopic superior hypogastric plexus block regarding to total opioid for postoperative analgesia after laparoscopic hysterectomy and patient satisfaction. To record side effects related to regional block ( e.g., local anesthetic toxicity, vascular and neural injury) and opioids ( neasuea, vomiting, respiratory depression

Conditions

Post Hysterectomy Pain

Study Design

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

Study Groups

Group QL:

patients will receive Ultrasound Guided bilateral QL lumborum block (Anterior Approch) by anesthesiologist (20 ml of 0.25% bupivacaine hydrochloride at each side).

Group Type: EXPERIMENTAL

Quadratus Lamborum versus superior hypogatric

Intervention Type: PROCEDURE

Ultrasound Guided Quadratus Lumborum Block versus Laparoscopic Superior Hypogastric Plexus Block for Postoperative Analgesia after Laparoscopic Hysterectomy

Group SH:

will receive laparoscopic Superior Hypogastric block by gynecologist (30 ml of 0.25% bupivacaine hydrochloride ).

Group Type: EXPERIMENTAL

Quadratus Lamborum versus superior hypogatric

Intervention Type: PROCEDURE

Ultrasound Guided Quadratus Lumborum Block versus Laparoscopic Superior Hypogastric Plexus Block for Postoperative Analgesia after Laparoscopic Hysterectomy

Interventions

Quadratus Lamborum versus superior hypogatric

Ultrasound Guided Quadratus Lumborum Block versus Laparoscopic Superior Hypogastric Plexus Block for Postoperative Analgesia after Laparoscopic Hysterectomy

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

1. Written informed consent from the patient.

2. BMI of less than or equal 30.0 kg m-2.

3. Age 45-60 years old.

Exclusion Criteria

1. Allergy to local anesthetics. 2. Infection at site of injection. 3. Patients with coagulopathy. 4. Patients with chronic pain syndromes. 5. Physical and mental disease which could interfere with pain scores evaluation.

6. Patients with distorted local anatomy.

• Minimum Eligible Age: 45 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

Zagazig University

OTHER_GOV

Sponsor Role: lead

Responsible Party

Abdalla Mohamed Goda Mohamed

Abdalla mohamed goda mohamed ,MD

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Eslam S Almaghawry Mohamed, MD

Role: STUDY_CHAIR

Faculty of medicine, Zagazig university

Abdalla H Gad, MD

Role: STUDY_CHAIR

Faculty of medicine, zagazig university

Mohamed A Wasfy, MD

Role: STUDY_CHAIR

Faculty of medicine, zagazig university

Locations

Faculty of medicine, Zagazig university

Zagazig, Sharqia Province, Egypt

Countries

Egypt

References

Blanton E, Lamvu G, Patanwala I, Barron KI, Witzeman K, Tu FF, As-Sanie S. Non-opioid pain management in benign minimally invasive hysterectomy: A systematic review. Am J Obstet Gynecol. 2017 Jun;216(6):557-567. doi: 10.1016/j.ajog.2016.12.175. Epub 2016 Dec 30.

Reference Type: BACKGROUND

PMID: 28043841 (View on PubMed)

Gerbershagen HJ, Aduckathil S, van Wijck AJ, Peelen LM, Kalkman CJ, Meissner W. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology. 2013 Apr;118(4):934-44. doi: 10.1097/ALN.0b013e31828866b3.

Reference Type: BACKGROUND

PMID: 23392233 (View on PubMed)

Other Identifiers

271/7

Identifier Type: -

Identifier Source: org_study_id