Comparison of Analgesic Efficacy ESP Block and QLB II in Kidney Transplantation

NCT06660953 | Completed Phase 4

• 2 other identifiers: ESB vs QLB in transplatation2022/172
• Study Type: interventional
• Target: 66
• Locations: 1 country
• Sites: 1

Brief Summary

Renal transplantation is an increasingly common surgery in recent years. Opioid and/or NSAID use is common in postoperative pain management. However, these drugs have many side effects. Peripheral blocks provide more effective analgesia both intra and postoperatively, and also reduce the use of systemic drugs. The aim of this study was to compare the effects of two different nerve blocks (ESP vs QLB II) on intraoperative remifentanil dose and postoperative analgesia.

Conditions

Postoperative Analgesia; Intraoperative Analgesia

Keywords

errector spina plane block; quadratus lumborum block; postoperative pain

Outcome Measures

Primary Outcomes (1)

• Effectiveness of postoperative analgesia

  visuel analog score \< 3

  postoperative 24 hours

Secondary Outcomes (1)

• consumption of add analgesic dos

  postoperative 24 hours

Study Arms (3)

Group E

ACTIVE COMPARATOR

Group that Erector spinae plane block was applied.

Procedure: Erector Spinae Plane Block

Grup Q

ACTIVE COMPARATOR

Group that Quadratus lumborum type II block was applied

Procedure: Quadratus Lumborum Block (QLB)

Group K

NO INTERVENTION

no block was applied

Interventions

Erector Spinae Plane Block PROCEDURE

For ESP, high frequency linear ultrasound probe was planned transversely to the midline and spinous features were visualized. Cervical C7 and T7 vertebrae at the lower end of the scapula, which were accepted as landmarks, were determined and marked with a sterile surgical drawing pen. According to these landmarks, the USG probe was moved 2-3 cm laterally towards the points where kidney transplantation was planned at the T10 vertebral level, and the transverse parts, trapezius, latissimus dorsi, serratus and erector spina muscles were visualized. Using the block needle that can be visualized on USG with in-plane surgery, the skin, subcutaneous tissue and trapezius, latissimus dorsi, serratus and erector spina muscles were passed in a cranio caudal direction and the needle location was confirmed by hydrodissection with 2-5 ml of serum. The distribution of the block procedure and the spread of local anesthetic were linearly visualized with 10 ml bupivacaine and 10 ml 0.9% saline.

Group E

Quadratus Lumborum Block (QLB) PROCEDURE

The QL block II was done under aseptic technique, in lateral position with the side intended to block side up. A high frequency ultrasound linear probe covered in sterile sheath was placed anterior and superior to the iliac crest. The three anterior abdominal muscles were visualized. The external oblique muscle was followed posterolaterally until its posterior border was identified. Subsequently, the probe was tilted towards the attachment site of both the internal and external oblique muscles over the quadratus (QL) muscle until the midline of the thoracolumbar fascia was seen as a bright hyperechogenic line located between the posterior border of the quadratus lumborum muscle and the middle thoraco-lumbar fascia (anterior to latissiumus dorsi and erector spinae muscles). A 22-gauge Facet-tip SonoPlex needle of appropriate length estimated from the depth and length of required needle trajectory during scout scanning was inserted via in-plane technique. The needle was directed from a

Grup Q

Eligibility Criteria

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

You may not qualify if:

• Patients with a history of allergy to general and local anesthetics to be used, inability to understand or participate in pain scoring, inability to use the PCA pump, or conditions that prevent the performance of trunkal blocks (anatomical or postoperative deformations in the region)

Sponsors & Collaborators

• University of Gaziantep: lead

Study Sites (1)

University of Gaziantep

Gaziantep, 27031, Turkey (Türkiye)

Location

Related Publications (3)

• Atici E, Arslan ZI, Yilmaz H. Effect of erector spinae plane block on postoperative intravenous morphine consumption in open subcostal nephrectomy: A prospective randomized clinical trial. Agri. 2024 Jan;36(1):13-21. doi: 10.14744/agri.2022.71602.

  PMID: 38239121 RESULT

• Kolacz M, Mieszkowski M, Janiak M, Zagorski K, Byszewska B, Weryk-Dysko M, Onichimowski D, Trzebicki J. Transversus abdominis plane block versus quadratus lumborum block type 2 for analgesia in renal transplantation: A randomised trial. Eur J Anaesthesiol. 2020 Sep;37(9):773-789. doi: 10.1097/EJA.0000000000001193.

  PMID: 32175985 RESULT

• Kim Y, Kim JT, Yang SM, Kim WH, Han A, Ha J, Min S, Park SK. Anterior quadratus lumborum block for analgesia after living-donor renal transplantation: a double-blinded randomized controlled trial. Reg Anesth Pain Med. 2024 Aug 5;49(8):550-557. doi: 10.1136/rapm-2023-104788.

  PMID: 37704438 RESULT

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

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

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Asistant professor

Model Details: randomised controlled clinical study

Study Record Dates

• First Submitted: October 24, 2024
• First Posted: October 28, 2024
• Study Start: September 30, 2022
• Primary Completion: February 28, 2023
• Study Completion: March 30, 2023
• Last Updated: October 28, 2024

Record last verified: 2024-10

Locations

TU (1)