Comparison of Two Approaches of Quadratus Lumborum Block for Post-operative Analgesia in Radical Cystectomy

Assiut University

Status: Enrolling

Conditions: Quadratus Lumborum Block

Treatments: Procedure: US guided injection

Study type: Interventional

Funder types: Other

Identifiers

NCT05089994

01060264751

Details and patient eligibility

About

To compare the postoperative analgesic effect of two ultrasound guided approaches of quadratus lumborum block (QLB) (anterior and intramuscular) for radical cystectomy.

Full description

The quadratus lumborum block (QLB) is one of the abdominal wall block techniques used to anesthetize thoracolumbar nerves . The QLB technique was described initially by Blanco et al. in 2007 (not published), then reported initially by Kadam in 2013. Since then, QLB has evolved with the development of the ultrasound-guided nerve block. To date, several randomized controlled trials have reported effective postoperative analgesia, with non-intramuscular QLB for cesarean sections, laparoscopic gynecologic surgery and hip hemiarthroplasty .

The intramuscular QLB (QLBi) technique was first reported by. This approach is different from others in tubouchi for QLB; although the injection target sites of the other approaches are planes around the quadratus lumborum muscle, the intramuscular approach penetrates the fascia of the quadratus lumborum muscle, where local anesthetics are injected. Therefore, QLBi is relatively easier to perform compared with other QLB approaches.

The incidence of urinary bladder cancer in the Middle East and Africa is greater in areas with high rather than low SH prevalence.

Enrollment: 60 estimated patients

Sex: All

Ages: 40 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age: 40-70years.

  • BMI: 20-30 kg.m2
  • Sex: both males and females.
  • American Society of Anesthesiologists (ASA )physical status: I-III.
  • Operation: radical cystectomy

Exclusion criteria

• • Patient's refusal to participate in the study.

  • known allergy to local anesthesia (LA),
  • coagulopathy or thrombocytopenia,
  • body mass index (BMI) above 30 kg .m 2, and infection at site of injection.
  • Chronic pain syndromes,
  • Prolonged opioid medication,
  • Patients on regular use of analgesic or who received analgesic 24 h before surgery

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

---

60 participants in 2 patient groups

Group 1 (QLBA) will include 30 patients

Experimental group

Description:

will receive ultrasound-guided anterior approach quadratus lumborum block

Treatment:

Procedure: US guided injection

Group 2 (QLBI)will include 30 patients.

Experimental group

Description:

received ultrasound-guided intramuscular quadratus lumborum.

Treatment:

Procedure: US guided injection