ITM vs QL for Pediatric Open Lower Abdominal Procedures

Medical University of South Carolina (MUSC)

Status and phase: Terminated; Phase 4

Conditions: Pediatrics; Pain Control; Intrathecal Morphine; Ureteral Reimplantation

Treatments: Drug: Quadratus lumborum block; Drug: Intrathecal Morphine

Study type: Interventional

Funder types: Other

Identifiers

NCT05506930

Pro00121082

Details and patient eligibility

About

Patients between the ages of 12 months and 11 years who are undergoing an open lower abdominal procedure will be randomized to receive intrathecal morphine, or bilateral quadratus lumborum block. The investigators will compare the effect that intrathecal morphine and quadratus lumborum blocks have on the duration of pain control as demonstrated by charted pain scores and morphine equivalents in the first 48 hours. This study will also assess the side effects of each intervention such as nausea and vomiting, and itching.

Enrollment: 14 patients

Sex: All

Ages: 12 months to 11 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Ages 12 months to 11 years old
• Undergoing an open lower abdominal procedure

Exclusion criteria

• Allergy to morphine or amide local anesthetics
• Localized rash at site of planned regional anesthetic block
• Bleeding diathesis
• Spinal dysmorphism
• Previous spinal surgery with instrumentation of the lumbar spine
• Inability or unwillingness of parent or legal guardian to give informed consent.
• Prior enrollment and randomization in this study

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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14 participants in 2 patient groups

Intrathecal Morphine

Active Comparator group

Description:

Intrathecal Morphine: spinal (neuraxial) dose of preservative free morphine (duramorph), usually about 4-5mcg/kg

Treatment:

Drug: Intrathecal Morphine

quadratus lumborum block

Active Comparator group

Description:

Quadratus Lumborum Block: peripheral nerve block utilizing ropivacaine 0.2%, usually about ½ mL per kg per side (total dose approximately 1mL/kg).

Treatment:

Drug: Quadratus lumborum block