Comaprison Between QLB and ESPB in Patients for PCNL Operation

Assiut University

Status: Completed

Conditions: Pain, Postoperative

Treatments: Procedure: Subcostal Oblique Quadratus Lumborum Block and Erector Spinae Plain Block.

Study type: Interventional

Funder types: Other

Identifiers

NCT04277611

QLB and ESPB comparison

Details and patient eligibility

About

comparing the subcostal oblique Quadratus Lumborum block and the Erector Spinae plane block in patients undergoing percutaneous nephrolithotomy operation to get the best and longest postoperative analgesic effect.

Full description

Here the investigators are going to compare between the Anterior approach for the subcostal oblique Quadratus Lumborum block (QLB) and the Erector Spinae Plane Block (ESPB) to determine their level of spread and their value in controlling postoperative pain in patients scheduled for Percutaneous Nephrolithotomy surgery. We hypothesized that quadratus lumborum is not inferior regarding the duration of analgesia when compared to erector spinae in patients undergoing percutaneous nephrolithotomy under general anesthesia.

Enrollment: 92 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Both sex
• Age: 18-60
• ASA (American Society of Anesthesiologists) class I and II
• Elective surgery
• Patients undergoing PNL surgery

Exclusion criteria

• Patient's refusal
• Allergy or contraindications to drugs used in the study
• Emergency surgery
• Psychiatric disorders
• Severely co-morbid patients
• Inflammation or infection over injection site
• Bleeding diathesis; INR more than 1.5 and Platelet count less than 100,000/mm3
• Peripheral neuropathy
• Obese patients BMI ≥35
• Patients on previous opioid therapy
• Pre-operative haemoglobin <10 mg/dl
• Inability to properly describe postoperative pain to investigators
• Coagulation abnormalities
• History of drug addiction or alcohol abuse
• History of Previous renal surgery

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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92 participants in 2 patient groups

QLB

Active Comparator group

Description:

The patient is in the prone position, an ultrasound probe is placed in a transverse, oblique, and paramedian orientation approximately lateral to the posterior axillary line. The needle is then inserted in-plane from the medial side of the transducer and advanced laterally to enter the interfascial plane between the Quadratus Lumborum muscle and the kidney. We confirmed that the local anesthetic appeared to press down the kidney in the ultrasound image

Treatment:

Procedure: Subcostal Oblique Quadratus Lumborum Block and Erector Spinae Plain Block.

ESPB

Active Comparator group

Description:

Using aseptic technique, an ultrasound probe is placed at the T9 vertebral level. After identifying the ribs and sliding towards the midline in a longitudinal parasagittal orientation, the overlying Erector Spinae is identified by visualization of the transition between the rib and transverse apophysis a block needle is inserted in plane with ultrasound beam and is advanced in a cephalo-caudal direction until the tip contacted the transverse process.

Treatment:

Procedure: Subcostal Oblique Quadratus Lumborum Block and Erector Spinae Plain Block.