COMPARISON OF PLAIN BLOCKS FOR POSTOPERATIVE PAIN MANAGEMENT IN GYNECOLOGICAL ABDOMINAL SURGERIES (ESP QLB TAP)

Çukurova University

Status: Invitation-only

Conditions: Postoperative Pain Management; Plane Block; Gynecologic Surgical Procedures; Surgery With General Anesthesia

Treatments: Procedure: ESP Plane block; Other: No intervention; Procedure: QLB plane block; Procedure: TAP Block

Study type: Interventional

Funder types: Other

Identifiers

NCT07021105

Decision No. 145

Details and patient eligibility

About

This study compares the effects of transversus abdominis plane (TAP) block, quadratus lumborum block (QLB), and erector spinae plane block (ESP) on postoperative morphine consumption, pain scores, patient satisfaction, and side effects in patients undergoing gynecological abdominal laparotomy surgeries.

Full description

Patients will be randomly assigned into four groups using a computer-generated randomization method. According to group allocation, patients will receive the following interventions before extubation under ultrasound (US) guidance except control group:

Group E (n=20): Bilateral erector spinae plane (ESP) block will be performed with 40 ml of 0.25% bupivacaine (20 ml on each side) at the T12 level, approximately 3-4 cm laterally from the midline, in the neurofascial plane between the transverse processes and the erector spinae muscle.

Group Q (n=20): Bilateral quadratus lumborum block (QLB) will be performed with 40 ml of 0.25% bupivacaine (20 ml on each side), placed between the psoas major and quadratus lumborum muscles under US guidance, between the iliac crest and the 12th rib.

Group T (n=20): Bilateral transversus abdominis plane (TAP) block will be performed with 40 ml of 0.25% bupivacaine (20 ml on each side) in the neurofascial plane between the internal oblique and transversus abdominis muscles.

Group C (Control group, n=20): No block will be applied, only the standard intravenous patient-controlled analgesia (PCA) protocol will be used.

The primary aim of this study is to assess the morphine consumption in the postoperative period, while secondary aims include pain score, patient satisfaction, the need for rescue analgesia and side effects

Enrollment: 80 estimated patients

Sex: Female

Ages: 18 to 69 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

aged between 18 and 69 years, with ASA 1-2 score scheduled to undergo major gynecological abdominal surgery

Exclusion criteria

ASA score 3 or above, patients younger than 18 or older than 69 years, patients with bleeding disorders or using anticoagulants, patients with a body mass index over 40, patients with known allergies to any drugs used in the study, and patients who could not or did not wish to use Patient-Controlled Analgesia (PCA) device

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Sequential Assignment

Masking: Single Blind

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80 participants in 4 patient groups

Group E

Active Comparator group

Description:

Group ESP \& QLB, TAP, Control

Treatment:

Procedure: TAP Block

Procedure: QLB plane block

Other: No intervention

Group Q

Active Comparator group

Description:

Group QLB \& ESP, TAP, Control

Treatment:

Procedure: TAP Block

Other: No intervention

Procedure: ESP Plane block

Group T

Active Comparator group

Description:

Group T \& ESP, QLB, Control

Treatment:

Procedure: QLB plane block

Other: No intervention

Procedure: ESP Plane block

Group C

No Intervention group

Description:

Group C \& ESP, QLB, TAP