Comparison of Quadratus Lumborum Block and Epidural Analgesia Following Kidney Transplant Surgery

NCT03771339 | Completed

• 1 other identifier: IndonesiaUAnes030
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Quadratus lumborum block as an alternative for postoperative analgesia compared with epidural block

Conditions

Postoperative Pain

Keywords

quadratus lumborum block; continuous epidural; postoperative analgesia; kidney transplant

Outcome Measures

Primary Outcomes (1)

• Morphine consumption

  Additional analgesia required at 2, 6, 12, and 24 hours after surgery

  24 hours

Secondary Outcomes (8)

• Pain Intensity

  24 hours

• First time morphine required

  24 hours

• Total minimum and maximum dose of vasoactive agents

  24 hours

• Urine output

  24 hours

• Bromage score

  24 hours

Study Arms (2)

Continuous Epidural Analgesia

ACTIVE COMPARATOR

Continuous epidural analgesia using ropivacaine 0.375% 3 mL boluses followed by ropivacaine 0.2% with rate 6 mL per hour for 24 hours

Procedure: Continuous Epidural analgesia

Bilateral Quadratus Lumborum Block

EXPERIMENTAL

Bilateral Quadratus lumborum block using ropivacaine 0.2% 20 mL each injection after surgery

Procedure: Bilateral Quadratus Lumborum block

Interventions

Continuous Epidural analgesia PROCEDURE

Continuous Epidural catheter is inserted at the Thoracic 11-T12 level, using Ropivacaine 0.375% 3 mL bolus followed by Ropivacaine 0.2% with rate 6 mL/hour for 24 hours after laparoscopic nephrectomy

Continuous Epidural Analgesia

Bilateral Quadratus Lumborum block PROCEDURE

Bilateral anterior Quadratus Lumborum block using Ropivacaine 0.375% 20 mL each injection as postoperative analgesia treatment for 24 hours

Bilateral Quadratus Lumborum Block

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients undergoing elective kidney transplant laparotomy surgery
• Agrees to participate in research
• BMI \< 30 kg/m2

You may not qualify if:

• Declines to participate in research
• Contraindications to intervention procedures (epidural or quadratus lumborum block)
• History of local anaesthetic allergy
• Systemic allergic reactions, anaphylactic reaction, cardiac arrest
• Failure of intervention procedures (epidural or quadratus lumborum block)
• Intraoperative complications (massive bleeding, hypotension)

Sponsors & Collaborators

• Indonesia University: lead

Study Sites (1)

Rumah Sakit Cipto Mangunkusumo

Jakarta Pusat, DKI Jakarta, 10430, Indonesia

Location

Related Publications (32)

• Mochtar CA, Alfarissi F, Soeroto AA, Hamid ARAH, Wahyudi I, Marbun MBH, et al. Milestones of kidney transplantation in Indonesia. Med J Indones. 2017 Nov 27;26(3):229.

  BACKGROUND

• Kakaei F, Nikeghbalian S, Ali S. Kidney Transplantation Techniques. In: Rath T, editor. Current Issues and Future Direction in Kidney Transplantation [Internet]. InTech; 2013 [cited 2018 Jun 6]. Available from: http://www.intechopen.com/books/current-issues-and-future-direction-in-kidney-transplantation/kidney-transplantation-techniques

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  BACKGROUND

• Srivastava D, Tiwari T, Sahu S, Chandra A, Dhiraaj S. Anaesthetic management of renal transplant surgery in patients of dilated cardiomyopathy with ejection fraction less than 40%. Anesthesiol Res Pract. 2014;2014:525969. doi: 10.1155/2014/525969. Epub 2014 Aug 19.

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• S Martinez B. Anesthesia for Kidney Transplantation-A Review. J Anesth Clin Res [Internet]. 2013 [cited 2018 Jun 6];04(01). Available from: https://www.omicsonline.org/anesthesia-for-kidney-transplantation-a-review-2155-6148.1000270.php?aid=11555

  BACKGROUND

• Hirata ES, Baghin MF, Pereira RI, Alves Filho G, Udelsmann A. Influence of the anesthetic technique on the hemodynamic changes in renal transplantation: a retrospective study. Rev Bras Anestesiol. 2009 Mar-Apr;59(2):166-76. doi: 10.1590/s0034-70942009000200004. English, Portuguese.

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  PMID: 28154824 BACKGROUND

• Krohg A, Ullensvang K, Rosseland LA, Langesaeter E, Sauter AR. The Analgesic Effect of Ultrasound-Guided Quadratus Lumborum Block After Cesarean Delivery: A Randomized Clinical Trial. Anesth Analg. 2018 Feb;126(2):559-565. doi: 10.1213/ANE.0000000000002648.

  PMID: 29135590 BACKGROUND

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  PMID: 29512813 BACKGROUND

• Lemmens HJ. Kidney transplantation: recent developments and recommendations for anesthetic management. Anesthesiol Clin North Am. 2004 Dec;22(4):651-62. doi: 10.1016/j.atc.2004.05.007.

  PMID: 15541928 BACKGROUND

• Hockett MM, Hembrador S, Lee A. Continuous Quadratus Lumborum Block for Postoperative Pain in Total Hip Arthroplasty: A Case Report. A A Case Rep. 2016 Sep 15;7(6):129-31. doi: 10.1213/XAA.0000000000000363.

  PMID: 27513972 BACKGROUND

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  PMID: 20400617 BACKGROUND

• Tsai HC, Yoshida T, Chuang TY, Yang SF, Chang CC, Yao HY, Tai YT, Lin JA, Chen KY. Transversus Abdominis Plane Block: An Updated Review of Anatomy and Techniques. Biomed Res Int. 2017;2017:8284363. doi: 10.1155/2017/8284363. Epub 2017 Oct 31.

  PMID: 29226150 BACKGROUND

• Schmid S, Jungwirth B. Anaesthesia for renal transplant surgery: an update. Eur J Anaesthesiol. 2012 Dec;29(12):552-8. doi: 10.1097/EJA.0b013e32835925fc.

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• Ashok J, Mayur M, Asit K P, Neelam S.Postoperative Analgesia by Transmuscular Quadratus Lumborum Block Catheters. J Anest & Inten Care Med. 2016; 1(3) : 555562

  BACKGROUND

• Blanco R, Ansari T, Girgis E. Quadratus lumborum block for postoperative pain after caesarean section: A randomised controlled trial. Eur J Anaesthesiol. 2015 Nov;32(11):812-8. doi: 10.1097/EJA.0000000000000299.

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• Carline L, McLeod GA, Lamb C. A cadaver study comparing spread of dye and nerve involvement after three different quadratus lumborum blocks. Br J Anaesth. 2016 Sep;117(3):387-94. doi: 10.1093/bja/aew224.

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  PMID: 29103570 BACKGROUND

• Garg C, Khanna S, Mehta Y. Quadratus lumborum block for post-operative pain relief in patient with Prune belly syndrome. Indian J Anaesth. 2017 Oct;61(10):840-842. doi: 10.4103/ija.IJA_246_17.

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• Shaaban M, Esa WA, Maheshwari K, Elsharkawy H, Soliman LM. Bilateral Continuous Quadratus Lumborum Block for Acute Postoperative Abdominal Pain as a Rescue After Opioid-Induced Respiratory Depression. A A Case Rep. 2015 Oct 1;5(7):107-11. doi: 10.1213/XAA.0000000000000188.

  PMID: 26402020 BACKGROUND

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  BACKGROUND

• Brull R, MacFarlane AJR, Chan VWS. Spinal, Epidural, and Caudal Anesthesia. In: Miller RD, Cohen NH, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Young WL, editors. Miller's anesthesia. Eighth edition. Philadelphia, PA: Elsevier/Saunders; 2015. p. 1684-720

  BACKGROUND

• Butterworth JF, Mackey DC, Wasnick JD, Morgan GE, Mikhail MS, Morgan GE. Spinal, Epidural, & Caudal Blocks. In: Morgan and Mikhail's clinical anesthesiology. 5th ed. McGraw-Hill; 2013. p. 937-74

  BACKGROUND

• Clemente A, Carli F. The physiological effects of thoracic epidural anesthesia and analgesia on the cardiovascular, respiratory and gastrointestinal systems. Minerva Anestesiol. 2008 Oct;74(10):549-63.

  PMID: 18854796 BACKGROUND

• Wheatley RG, Schug SA, Watson D. Safety and efficacy of postoperative epidural analgesia. Br J Anaesth. 2001 Jul;87(1):47-61. doi: 10.1093/bja/87.1.47. No abstract available.

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• Grass JA. Patient-controlled analgesia. Anesth Analg. 2005 Nov;101(5 Suppl):S44-S61. doi: 10.1213/01.ANE.0000177102.11682.20.

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  PMID: 14499670 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Officials

• Dita Aditianingsih, M.D.

  Indonesia University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator, Anesthesiologist Consultant

Study Record Dates

• First Submitted: December 6, 2018
• First Posted: December 11, 2018
• Study Start: December 10, 2018
• Primary Completion: January 31, 2020
• Study Completion: January 31, 2020
• Last Updated: October 28, 2020

Record last verified: 2020-10

Locations

ID (1)