Comparison of Quadratus Lumborum Block and Erector Spina Plane Block in Nephrectomy

NCT04459624 | Completed

• 1 other identifier: ESOGU 2
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Postoperative pain is important due to the limitation of physical functions, delay in recovery of quality of life, long-term opiate use, length of hospital stay, increased care costs and early postoperative pain trigger chronic pain. It is associated with postoperative morbidity. Multimodal analgesia techniques with fascial plan blocks are frequently used.The investigators aimed to evaluate the effect of QLB2 and ESP on postoperative pain scores in nephrectomy surgery, total opiate consumption, initial analgesia requirement, additional analgesia consumption, patient and surgeon satisfaction.

Conditions

Pain, Postoperative; Postoperative Complications

Keywords

Erector Spina Plan Block; Quadratus Lumborum Block; Nephrectomy; Postoperative Pain

Outcome Measures

Primary Outcomes (1)

• Effect of QLB2 and ESP on postoperative pain scores in nephrectomy surgery

  Visual analog scale at rest and movement (0 (no pain)-10 (unbearable pain))

  24 hours

Secondary Outcomes (1)

• Total opiate consumption

  24 hours

Study Arms (2)

ESP block

ACTIVE COMPARATOR

Intervention: Erector Spina Plane Block will administer with 20 ml of % 0.25 bupivacaine

Procedure: Erector Spina Plane Block

QLB 2 block

ACTIVE COMPARATOR

Intervention: Quadratus Lumborum Block 2 will administer with 20 ml of % 0.25 bupivacaine

Procedure: Quadratus Lumborum Block 2

Interventions

Erector Spina Plane Block PROCEDURE

Group E (ESP block) will be applied 20 ml of % 0.25 bupivacaine between the erector spina muscle and transverse process at the 8th thoracic level. The blocks will be administered under general anesthesia in lateral position by the same anesthesiologist.

Also known as: Fascial plane block at nephrectomy

ESP block

Quadratus Lumborum Block 2 PROCEDURE

Group Q (QLB2 block) lumbar interfacial triangle (LIFT) will be applied 20 ml of % 0.25 bupivacaine. The blocks will be administered under general anesthesia in lateral position by the same anesthesiologist.

Also known as: Fascial plane block at nephrectomy

QLB 2 block

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Partial or radical nephrectomy
• American Society of Anesthesiologist physical status I-III

You may not qualify if:

• Infection in the incision area
• Coagulation disorder
• Known allergy history against to the study drugs
• Lack of adequate cognitive activity in the use of patient-controlled analgesia and VAS

Sponsors & Collaborators

• Eskisehir Osmangazi University: lead

Study Sites (1)

Eskisehir Osmangazi Univercıty

Odunpazari, Eskişehir, 26040, Turkey (Türkiye)

Location

Related Publications (4)

• Aksu C, Sen MC, Akay MA, Baydemir C, Gurkan Y. Erector Spinae Plane Block vs Quadratus Lumborum Block for pediatric lower abdominal surgery: A double blinded, prospective, and randomized trial. J Clin Anesth. 2019 Nov;57:24-28. doi: 10.1016/j.jclinane.2019.03.006. Epub 2019 Mar 6.

  PMID: 30851499 BACKGROUND

• Ueshima H, Otake H, Lin JA. Ultrasound-Guided Quadratus Lumborum Block: An Updated Review of Anatomy and Techniques. Biomed Res Int. 2017;2017:2752876. doi: 10.1155/2017/2752876. Epub 2017 Jan 3.

  PMID: 28154824 BACKGROUND

• Oksuz G, Bilal B, Gurkan Y, Urfalioglu A, Arslan M, Gisi G, Oksuz H. Quadratus Lumborum Block Versus Transversus Abdominis Plane Block in Children Undergoing Low Abdominal Surgery: A Randomized Controlled Trial. Reg Anesth Pain Med. 2017 Sep/Oct;42(5):674-679. doi: 10.1097/AAP.0000000000000645.

  PMID: 28759502 BACKGROUND

• Yousef NK. Quadratus Lumborum Block versus Transversus Abdominis Plane Block in Patients Undergoing Total Abdominal Hysterectomy: A Randomized Prospective Controlled Trial. Anesth Essays Res. 2018 Jul-Sep;12(3):742-747. doi: 10.4103/aer.AER_108_18.

  PMID: 30283187 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative; Postoperative Complications

Condition Hierarchy (Ancestors)

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

Study Officials

• Meryem Onay, Dr

  Eskisehir Osmangazi University Faculty Of Medicine

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: In the postoperative period, the effectiveness and safety of the block will be evaluated by another researcher (blind) who does not know which group the patient is in.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Specialist Doctor-Anesthesiologist

Model Details: Group E: ESP block will be applied at the end of the operation. Patients will receive paracetamol 1gr 4 \* 1 and tramadol 1mg/kg 30 minutes before the end of the operation. All patients will undergo IV morphine patient-controlled analgesia (PCA). Pain, opioid consumption, hemodynamic parameters and complications will be monitored in the first 24 hours in the postoperative period. Group Q: QLB2 block will be applied at the end of the operation. Patients will receive paracetamol 1gr 4 \* 1 and tramadol 1mg / kg 30 minutes before the end of the operation. All patients will undergo IV morphine patient-controlled analgesia (PCA). Pain, opioid consumption, hemodynamic parameters and complications will be monitored in the first 24 hours in the postoperative period.

Study Record Dates

• First Submitted: June 23, 2020
• First Posted: July 7, 2020
• Study Start: July 20, 2020
• Primary Completion: July 20, 2021
• Study Completion: January 31, 2022
• Last Updated: February 4, 2022

Record last verified: 2022-02

Locations

TU (1)