Intrathecal Morphine vs. US-Guided Bilateral Posterior Quadratus Lumborum Block in Cesarean Section

NCT06481462 | Completed

• 1 other identifier: ITMQLB27
• Study Type: observational
• Target: 68
• Locations: 1 country
• Sites: 1

Brief Summary

In this study, it was aimed to evaluate the effects of intrathecal morphine and posterior quadratus lumborum block (QLB2) on postoperative acute pain scores and opioid consumption in the first 24 hours after cesarean section.

Conditions

Anesthesia; Postoperative Pain

Keywords

Cesarean section; intrathecal morphine; posterior quadratus lumborum block

Outcome Measures

Primary Outcomes (1)

• Morphine consumption in the first 24 hours after surgery

  Morphine consumption in the first 24 hours will be measured by IV PCA. Patients will be able to request opioids via a PCA device when their NRS score is above 4

  Postoperative day 1

Secondary Outcomes (5)

• Postoperative pain scores

  Postoperative day 1

• Postoperative nausea and vomiting (PONV) scores

  Postoperative Day 1

• The number of patient required rescue analgesic

  Postoperative Day 1

• Postoperative pruritus score

  Postoperative Day 1

• Patients' satisfaction and quality of pain management

  Postoperative Day 1

Study Arms (2)

Intrathecal Morphine

A subarachnoid block will be performed by injecting morphine 100 mcg + 12.5 mg hyperbaric bupivacaine + 20 mcg fentanyl.

Procedure: Intrathecal Morphine (ITM)

Posterior Quadratus Lumborum Block

Patients scheduled for elective cesarean section under spinal anesthesia will receive bilateral ultrasound-guided posterior quadratus lumborum block.

Procedure: Quadratus Lumborum II (QLB-II) Block

Interventions

Intrathecal Morphine (ITM) PROCEDURE

morphine 100 mcg + 12.5 mg bupivacaine + 20 mcg fentanyl

Intrathecal Morphine

Quadratus Lumborum II (QLB-II) Block PROCEDURE

12.5 mg bupivacaine + 20 mcg fentanyl bilateral QLB block (posterior tip 2) 25 cc 0.25% bupivacaine

Posterior Quadratus Lumborum Block

Eligibility Criteria

• Age: 18 Years - 45 Years
• Gender Eligibility Details: Patients scheduled for cesarean section at ≥37 weeks of gestation.
• Healthy Volunteers: No
• Age Groups: Adult (18-64)
• Sampling Method: Probability Sample

Study Population

The study population consisted of pregnant women who were at least 37 weeks gestational age, aged between 18 and 45 years, with an ASA (American Society of Anesthesiologists) physical status score of II, scheduled for elective cesarean section under spinal anesthesia between July 1, 2024, and October 20, 2024, and who received either a posterior quadratus lumborum block (QLB-II) or intrathecal morphine.

You may qualify if:

• Pregnant for at least 37 weeks
• Aged between 18 and 45
• ASA (American Society of Anesthesiologists) physical status score II
• Patient planned for elective cesarean section under spinal anesthesia
• Patient receiving QLB-II block or intrathecal morphine

You may not qualify if:

• ASA score of III or IV.
• Planned cesarean section under general anesthesia.
• Requirement for conversion to general anesthesia after failed spinal anesthesia.
• Contraindication to spinal anesthesia and regional anesthesia techniques.
• BMI greater than 35 kg/m².
• History of opioid use disorder or opioid use for more than 4 weeks.
• Inability to assess pain scores.
• Pregnancies of less than 37 weeks gestation.
• History of allergy to local anesthetics and systemic opioids.
• Patient refusal

Sponsors & Collaborators

• Ondokuz Mayıs University: lead

Study Sites (1)

Ondokuz Mayıs University

Samsun, Turkey (Türkiye)

Location

Related Publications (3)

• Salama ER. Ultrasound-guided bilateral quadratus lumborum block vs. intrathecal morphine for postoperative analgesia after cesarean section: a randomized controlled trial. Korean J Anesthesiol. 2020 Apr;73(2):121-128. doi: 10.4097/kja.d.18.00269. Epub 2019 Mar 8.

  PMID: 30852882 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

• Ozkan G, Kara U, Ince ME, Ozdemir O, Ulubay M, Senkal S. Validation of the Turkish version of the Obstetric Quality-of-Recovery score 11 (ObsQoR-11T) after cesarean delivery. Health Qual Life Outcomes. 2022 Nov 28;20(1):155. doi: 10.1186/s12955-022-02073-y.

  PMID: 36443784 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative

Interventions

Dental Occlusion

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Dentistry; Dental Physiological Phenomena; Digestive System and Oral Physiological Phenomena

Study Officials

• Burhan DOST

  Ondokuz Mayıs University

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Target Duration: 2 Days
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doc. Dr

Study Record Dates

• First Submitted: June 25, 2024
• First Posted: July 1, 2024
• Study Start: July 3, 2024
• Primary Completion: November 26, 2024
• Study Completion: December 26, 2024
• Last Updated: February 25, 2025

Record last verified: 2025-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)