Quadratus Lumborum Block Versus Erector Spinae Plane Block in Extracorporeal Shock Wave Lithotripsy(ESWL)

NCT05937256 | Completed

• 1 other identifier: Regional blocks in ESWL
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

This study is designed to compare analgesic effect of both the ultrasound (US)-guided QLB and ESPB blocks during ESWL and their effect on stone fragmentation.

Conditions

Pain; Lithiasis

Outcome Measures

Primary Outcomes (1)

• Analgesic Effect: cumulative opioid dose

  Comparing analgesic Effect of both QLB and ESPB by calculating the total opioid consumption over the total duration of session (approximately 30 minutes)

  At 30 minutes

Secondary Outcomes (7)

• Stone fragmentation: clearance rate

  one week after ESWL session

• Stone fragmentation: shockwave energy

  at 30 minutes

• Block failure rate

  Immediately After 20 minutes of intervention

• The regional block time

  procedure (At the end of intervention)

• Feasibility of visualisation

  procedure (At the end of intervention)

Study Arms (3)

Group Q

ACTIVE COMPARATOR

(n=30) will receive unilateral quadratus lumborum block type III

Procedure: Quadratus lumborum block type III

Group E

ACTIVE COMPARATOR

(n=30) will receive unilateral erector spinae plane block

Procedure: Erector spinae plane block

Group C

NO INTERVENTION

(n=30) will be control group receiving no intervention, managed only with conventional analgesia

Interventions

Quadratus lumborum block type III PROCEDURE

Patients will be placed in lateral decubitus position with the side of the target stone facing up. After sterilization and draping of the skin, using US probe the block will be applied targeting the fascial plane between the quadratus lumborum and psoas major muscles (anterior aspect of the quadratus lumborum). After 20 min, sensory blockade will be evaluated with pinprick test, if loss of sensation is achieved at the T7-L1 dermatome site, the block is considered successful and patients will be transferred to ESWL Room.

Group Q

Erector spinae plane block PROCEDURE

Patients will be placed in the lateral decubitus position according to the selected site. After sterilization and draping of the skin, using US probe, the block will be applied in the plane deep to the erector spinae muscles and superficial to the transverse process. After 20 min, sensory blockade will be assessed with pinprick test, if loss of sensation is achieved at the T7-L1 dermatome site, the block is considered successful and patients is transferred to ESWL Room.

Group E

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Informed written consent obtained
• Age 18-60
• Both sex
• American Society of Anesthesiologists(ASA) physical status: I, II
• Stone pelvis less than 2.5 cm
• Indicated for ESWL

You may not qualify if:

• refusal of participation by parents or caregivers.
• ASA physical status: \> II
• Stone pelvis \>2.5 cm
• Chronic pain
• On chronic NSAID or opioid
• Substance addict
• Known local anesthetic drug sensitivity.
• Preexisting infection at block site
• Coagulopathy or anticoagulation.

Sponsors & Collaborators

• South Valley University: lead

Study Sites (1)

South Valley University

Qina, Qena Governorate, 83523, Egypt

Location

Related Publications (5)

• Yayik AM, Ahiskalioglu A, Alici HA, Celik EC, Cesur S, Ahiskalioglu EO, Demirdogen SO, Karaca O, Adanur S. Less painful ESWL with ultrasound-guided quadratus lumborum block: a prospective randomized controlled study. Scand J Urol. 2019 Dec;53(6):411-416. doi: 10.1080/21681805.2019.1658636. Epub 2019 Sep 9.

  PMID: 31496381 BACKGROUND

• Yayik AM, Celik EC, Ahiskalioglu A. An unusual usage for ultrasound guided Quadratus Lumborum Block: Pediatric extracorporeal shock wave lithotripsy. J Clin Anesth. 2018 May;46:47-48. doi: 10.1016/j.jclinane.2018.01.016. Epub 2018 Mar 26. No abstract available.

  PMID: 29414615 BACKGROUND

• Bovelander E, Weltings S, Rad M, van Kampen P, Pelger RCM, Roshani H. The Influence of Pain on the Outcome of Extracorporeal Shockwave Lithotripsy. Curr Urol. 2019 Mar 8;12(2):81-87. doi: 10.1159/000489424.

  PMID: 31114465 BACKGROUND

• Oh SK, Lim BG, Won YJ, Lee DK, Kim SS. Analgesic efficacy of erector spinae plane block in lumbar spine surgery: A systematic review and meta-analysis. J Clin Anesth. 2022 Jun;78:110647. doi: 10.1016/j.jclinane.2022.110647. Epub 2022 Jan 11.

  PMID: 35030493 BACKGROUND

• El-Boghdadly K, Desai N, Halpern S, Blake L, Odor PM, Bampoe S, Carvalho B, Sultan P. Quadratus lumborum block vs. transversus abdominis plane block for caesarean delivery: a systematic review and network meta-analysis. Anaesthesia. 2021 Mar;76(3):393-403. doi: 10.1111/anae.15160. Epub 2020 Jul 4.

  PMID: 32621529 BACKGROUND

MeSH Terms

Conditions

Pain; Lithiasis

Condition Hierarchy (Ancestors)

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

Study Officials

• Mohamed G Ahmed, MD

  Lecturer in anesthesiology intensive care and pain management, South Valley 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: Lecturer in anesthesiology, intensive care and pain management

Model Details: controlled, randomized, assessor blinded clinical trial.

Study Record Dates

• First Submitted: May 28, 2023
• First Posted: July 10, 2023
• Study Start: December 1, 2023
• Primary Completion: September 1, 2024
• Study Completion: December 1, 2024
• Last Updated: March 19, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)