Determination Of Dispersion In Ultrasound Guided Quadratus Lumborum Block In Cadavers

Federal University of São Paulo

Status: Unknown

Conditions: Nerve Block

Treatments: Procedure: Quadratus Lumborum Block type 3; Procedure: Quadratus Lumborum Block type 2

Study type: Interventional

Funder types: Other

Identifiers

NCT03545295

Quadratus Lumborum Block

Details and patient eligibility

About

Lumbar Quadrant Blockade is a recent analgesic technique consisting of the injection of local anesthetic around the lumbar square muscle. It was initially described as a technique for abdominal wall analgesia, but later studies have increased the range of indications for laparoscopic and lower limb surgeries. There are several techniques described but with differences in the literature at the point of injection and volume of anesthetic. The exact mechanism of visceral analgesia has not yet been determined. The objective of this study is to determine the dispersion of local anesthetic as a variable dependent on the volume of local anesthetic and injection site and elucidate the mechanisms of analgesia.

Full description

After the free and informed consent signed by the family authorizing the procedure, demographic and clinical data will be collected from the medical records of the deceased. The corpse will be weighed, measured and placed on the autopsy table. Blockade randomization (QLB 2 or QLB 3) and volume of local anesthetic (10ml, 20ml, 30ml) will be performed for each side. Injection in the anterior or posterior plane to the Lumbar Quadrant muscle will be performed by anesthesiologists experienced in the technique with ultrasound aid. A colouring solution will be used. After confirming the correct needle position, the previously randomized volumes will be injected. After the blockage, the corpse will be placed in the supine position and will be submitted to autopsy by standard procedure. After removal of the thoracic and abdominal viscera, the investigators will verify the dispersion of the local anesthetic. Photographic records will be made and the number of levels by which the solution dispersed will be annotated, calculating the number of cranial and caudal levels. The corpse will then have its autopsy procedure completed, with the placement of the viscera and incision closure according to the service standard.

Enrollment: 20 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Fresh corpses - not subjected to a formaldehyde process or frozen for more than 24 hours
• Age ≥ 18 years.
• Free, informed and informed consent signed by relatives or guardians of the body.
• Height> 150 cm and <190 cm

Exclusion criteria

• Previous spinal surgery.
• Significant spinal deformity
• Body mass index (BMI) ≥ 35 kg / m2
• Absence of relatives or guardians who can sign the written consent

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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20 participants in 6 patient groups

QLB 2 10ml

Experimental group

Description:

The cadaver will receive an ultrasound- guided Quadratus Lumborum Block type 2 with 10 ml coloring solution

Treatment:

Procedure: Quadratus Lumborum Block type 2

QLB 2 20ml

Experimental group

Description:

The cadaver will receive an ultrasound- guided Quadratus Lumborum Block type 2 with 20 ml coloring solution

Treatment:

Procedure: Quadratus Lumborum Block type 2

QLB 2 30ml

Experimental group

Description:

The cadaver will receive an ultrasound- guided Quadratus Lumborum Block type 2 with 30 ml coloring solution

Treatment:

Procedure: Quadratus Lumborum Block type 2

QLB 3 10ml

Experimental group

Description:

The cadaver will receive an ultrasound- guided Quadratus Lumborum Block type 3 with 10 ml coloring solution

Treatment:

Procedure: Quadratus Lumborum Block type 3

QLB 3 20ml

Experimental group

Description:

The cadaver will receive an ultrasound- guided Quadratus Lumborum Block type 3 with 20 ml coloring solution

Treatment:

Procedure: Quadratus Lumborum Block type 3

QLB 3 30ml

Experimental group

Description:

The cadaver will receive an ultrasound- guided Quadratus Lumborum Block type 3 with 30 ml coloring solution

Treatment:

Procedure: Quadratus Lumborum Block type 3