Clinical Efficacy and Safety of Dexmedetomidine as an Adjuvant in Quadratus Lumborum Versus Epidural Block in Postoperative Lower Abdominal Cancer Surgeries

NCT06130670 | Completed

• 1 other identifier: dexmedetomidine as an adjuvant
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

Clinical efficacy and safety of dexmedetomidine as an adjuvant in quadratus lumborum versus epidural block in postoperative patients

Conditions

To Compare Efficacy of Dexmedetomidine in Bilateral Quadratus Lumborum vs Lumbar Epidural Blocks on Analgesia After Major Lower Abdominal Surgery

Outcome Measures

Primary Outcomes (1)

• postoperative analgesia

  Time of first analgesic request during the first 24 hrs after surgery.

  the first 24 hrs after surgery

Study Arms (2)

Group1:Ultrasound-guided quadratus lumborum block technique

OTHER

Ultrasound-guided quadratus lumborum block technique: the patients were placed in the lateral position. Following disinfecting of the site of injection, a convex probe (2-5 HZ, Edge, Sonosite, Seattle, the USA) was positioned in a parasagittal oblique plane at the L3-L4 level, which is approximately 4 cm from the posterior midline. The iliac crest, erector spinae (ES) muscle, QL muscle, and psoas (PM) muscle were identified, and a an 18-gauge Touhy's epidural needle (BBRAUN epidural set) was directed to the anterior part of the QL. Then, the needle tip was located between the QL and PM using the in-plane technique. Normal saline 5 mL was used to identify the plane. After confirmation of the injection site, 20 ml of 0.25% Bupivacaine bolus was injected and 1 μg/kg of dexmedetomidine dissolved in 2 ml normal saline were injected also between the QL and PM muscles divided equally on each side of the abdominal wall before induction general anesthesia.

Other: nerve block

Group2:Lumbar epidural block

OTHER

Lumbar epidural block: Under strict aseptic precautions, lumbar epidural was performed for patients in Group II using a 16-gauge Touhy epidural needle by a median approach. The L3 - L4 interspaces was chosen for the injection. The epidural space identified by the loss of resistance technique. The catheter was advanced 4 cm cephalad. When the aspiration test results for blood and cerebrospinal fluid were negative, a test dose of (3 mL) 2% lidocaine was given after the placement of the epidural catheter. In the epidural catheter a bolus dose of 15 ml bupivacaine 0.25% and 1 μg/kg of dexmedetomidine dissolved in 2 ml normal saline was injected before induction of general anesthesia.

Other: nerve block

Interventions

nerve block OTHER

Comparing the efficacy of Dexmedetomidine in bilateral quadratus lumborum block versus lumbar epidural block on postoperative analgesia following major lower abdominal cancer surgery.

Group1:Ultrasound-guided quadratus lumborum block technique; Group2:Lumbar epidural block

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• patient's 18-70years old
• ASA I-II and NYHA I-II.
• type of surgery: major lower abdominal cancer surgery

You may not qualify if:

• Patients who refused to participate in the study.
• coagulation disorders.
• opioid dependence.
• sepsis or local infection at or near the vicinity of the block site.
• patients with psychiatric illnesses that would interfere with perception and assessment of pain.
• allergy to any of the studied drugs.

Sponsors & Collaborators

• Assiut University: lead

Study Sites (1)

Assiut University

Asyut, Egypt

Location

Related Publications (3)

• Xu W, Daneshmand S, Bazargani ST, Cai J, Miranda G, Schuckman AK, Djaladat H. Postoperative Pain Management after Radical Cystectomy: Comparing Traditional versus Enhanced Recovery Protocol Pathway. J Urol. 2015 Nov;194(5):1209-13. doi: 10.1016/j.juro.2015.05.083. Epub 2015 Aug 13.

  PMID: 26021824 BACKGROUND

• Patel HD, Ball MW, Cohen JE, Kates M, Pierorazio PM, Allaf ME. Morbidity of urologic surgical procedures: an analysis of rates, risk factors, and outcomes. Urology. 2015 Mar;85(3):552-9. doi: 10.1016/j.urology.2014.11.034.

  PMID: 25733265 BACKGROUND

• Bhalla RG, Wang L, Chang SS, Tyson MD. Association between Preoperative Albumin Levels and Length of Stay after Radical Cystectomy. J Urol. 2017 Nov;198(5):1039-1045. doi: 10.1016/j.juro.2017.05.066. Epub 2017 May 19.

  PMID: 28533006 BACKGROUND

MeSH Terms

Interventions

Nerve Block

Intervention Hierarchy (Ancestors)

Anesthesia, Conduction; Anesthesia; Anesthesia and Analgesia; Denervation; Neurosurgical Procedures; Surgical Procedures, Operative

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: resident doctor/Demonstrator

Model Details: Comparing the efficacy of Dexmedetomidine in bilateral quadratus lumborum block versus lumbar epidural block on postoperative analgesia following major lower abdominal cancer surgery

Study Record Dates

• First Submitted: November 5, 2023
• First Posted: November 14, 2023
• Study Start: April 20, 2024
• Primary Completion: December 31, 2024
• Study Completion: December 31, 2024
• Last Updated: December 1, 2025

Record last verified: 2025-11

Locations

EG (1)