Analgesic Efficacy of Transmuscular Quadratus Lumborum in Patients Undergoing Total Abdominal Hysterectomy
Transmuscular Quadratus Lumborum Block for Postoperative Pain After Total Abdominal Hysterectomy
1 other identifier
interventional
64
1 country
1
Brief Summary
Patients who have undergone laparotomies often require multimodal postoperative pain regimes. In recent years, abdominal wall blocks have been included to become part of this in order to overcome side effects of systemic opioids and complications from epidural analgesia. Borglum popularised a new approach on abdominal wall blocks by introducing the transmuscular quadratus lumborum (QL) block. Transmuscular QL block is thought to be effective against somatic and visceral pain as local anaesthetic tends to spread from the site of injection to thoracic paravertebral spaces where the sympathetic chain lies. The objective of this study is to evaluate the analgesic efficacy of transmuscular QL block in patients undergoing total abdominal hysterectomy (TAH) by measuring cumulative opioid consumption, pain score at rest and on movement 24 hours after TAH. Our hypothesis is patients given transmuscular QL block will have lower cumulative opioid consumption.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for not_applicable
Started Nov 2015
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
October 23, 2015
CompletedFirst Posted
Study publicly available on registry
October 26, 2015
CompletedStudy Start
First participant enrolled
November 1, 2015
CompletedPrimary Completion
Last participant's last visit for primary outcome
January 1, 2017
CompletedStudy Completion
Last participant's last visit for all outcomes
January 1, 2017
CompletedJune 20, 2017
June 1, 2017
1.2 years
October 23, 2015
June 18, 2017
Conditions
Keywords
Outcome Measures
Primary Outcomes (2)
Cumulative morphine consumption
in mg for 24 hours
24 hours after total abdominal hysterectomy
Pain score at rest and movement
using visual analogue scale 1 to 10
24 hours after total abdominal hysterectomy
Secondary Outcomes (1)
Complications related to the transmuscular QL block
24 hours after total abdominal hysterectomy
Study Arms (2)
Transmuscular quadratus lumborum (QL) block
EXPERIMENTALBilateral QL block using 20 ml 0.375% ropivacaine in each side (to a maximum dose 3 mg/kg) plus patient controlled analgesia morphine (1mg/bolus morphine, lockout time 5 minutes) post operative
Control
ACTIVE COMPARATORPatient controlled analgesia morphine (1mg/bolus morphine, lockout time 5 minutes) post operative
Interventions
Eligibility Criteria
You may qualify if:
- ASA I or II
- Patient's weight \> 50kg
- Elective TAH
You may not qualify if:
- Body mass index (BMI) \> 35 kg/m2
- Any contraindications to peripheral nerve blocks i.e. local skin infection, coagulopathy, allergy to LA
- Inability to use patient controlled analgesia
- Patient on antiplatelet, anticoagulant or on regular use of opioids, paracetamol, nonsteroidal anti-inflammatory drugs or tramadol for chronic condition
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Hospital Kuala Lumpur
Kuala Lumpur, 50586, Malaysia
Related Publications (6)
Hebbard P, Fujiwara Y, Shibata Y, Royse C. Ultrasound-guided transversus abdominis plane (TAP) block. Anaesth Intensive Care. 2007 Aug;35(4):616-7. No abstract available.
PMID: 18020088BACKGROUNDAbdallah FW, Laffey JG, Halpern SH, Brull R. Duration of analgesic effectiveness after the posterior and lateral transversus abdominis plane block techniques for transverse lower abdominal incisions: a meta-analysis. Br J Anaesth. 2013 Nov;111(5):721-35. doi: 10.1093/bja/aet214. Epub 2013 Jun 27.
PMID: 23811424BACKGROUNDCarney J, Finnerty O, Rauf J, Bergin D, Laffey JG, Mc Donnell JG. Studies on the spread of local anaesthetic solution in transversus abdominis plane blocks. Anaesthesia. 2011 Nov;66(11):1023-30. doi: 10.1111/j.1365-2044.2011.06855.x. Epub 2011 Aug 18.
PMID: 21851346BACKGROUNDKadam VR. Ultrasound-guided quadratus lumborum block as a postoperative analgesic technique for laparotomy. J Anaesthesiol Clin Pharmacol. 2013 Oct;29(4):550-2. doi: 10.4103/0970-9185.119148.
PMID: 24249997BACKGROUNDKadam VR. Ultrasound guided quadratus lumborum block or posterior transversus abdominis plane block catheter infusion as a postoperative analgesic technique for abdominal surgery. J Anaesthesiol Clin Pharmacol. 2015 Jan-Mar;31(1):130-1. doi: 10.4103/0970-9185.150575. No abstract available.
PMID: 25788791BACKGROUNDVisoiu M, Yakovleva N. Continuous postoperative analgesia via quadratus lumborum block - an alternative to transversus abdominis plane block. Paediatr Anaesth. 2013 Oct;23(10):959-61. doi: 10.1111/pan.12240. Epub 2013 Aug 9.
PMID: 23927552BACKGROUND
Related Links
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Amiruddin Nik Mohamed Kamil, MBBS MMed (Anaesthesiology)
Kuala Lumpur General Hospital
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- DOUBLE
- Who Masked
- PARTICIPANT, OUTCOMES ASSESSOR
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER GOV
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Dr
Study Record Dates
First Submitted
October 23, 2015
First Posted
October 26, 2015
Study Start
November 1, 2015
Primary Completion
January 1, 2017
Study Completion
January 1, 2017
Last Updated
June 20, 2017
Record last verified: 2017-06