Modified Paramedic Sagittal vs. Transverse TMQLB

Chinese Academy of Medical Sciences & Peking Union Medical College

Status: Completed

Conditions: Nerve Block

Treatments: Procedure: paramedian sagittal scan, in-plane, caudal-cranial TMQLB; Procedure: transverse scan, in-plane, posterior-anterior TMQLB

Study type: Interventional

Funder types: Other

Identifiers

NCT03771742

cuixule6

Details and patient eligibility

About

The classical transmuscular qudratus lumborum block(TMQLB) described by Borglum aims to provide lower thoracic paravertebral space(PVS) and sympathetic blockade by injecting local anesthetics between QL and PM muscle at the L3-L4 vertebral level using a transverse scan, posterior-anterior, in-plane approach. Recently, a paramedian sagittal oblique(TMQLB) approach has been introduced to facilitate cranial spread by injecting the local in a caudal to cranial direction. Currently, there are no data comparing the two techniques mentioned above with regards to extent of spread for PVS. Our objective is to investigate the extent of cranial dermatomal spread of TMQLB when equal dosage(ml/kg) of local anesthetic are injected with the transverse versus an modified paramedian sagittal approach for patients undergoing laparoscopic adrenalectomy. In addition, the investigators wish to compare the performance time, caudal dermatomal spread of TMQLB and postoperative analgesia effect.

Enrollment: 50 patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 18-70 yrs
• American Society of Anesthesiologists physical statusⅠ-Ⅲ
• Undergo laparoscopic adrenalectomy
• Informed consent
• Able to cooperate with study process

Exclusion criteria

• Allergy to local anesthetic and other medications used in the study
• Patient refusal or lack of informed consent
• Coexisting hematological disorder or with deranged coagulation parameters
• Pre-existing major organ dysfunction such as hepatic and renal failure
• History of previous renal surgery.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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50 participants in 2 patient groups

transverse TMQLB

Active Comparator group

Description:

Patients in this group will receive the transmuscular quadratus lumborum block before surgery using the transverse scan, in-plain, posterior to anterior approach. 0.6ml 0.375% ropivocaine was injected when the correct needle location is confirmed.

Treatment:

Procedure: transverse scan, in-plane, posterior-anterior TMQLB

paramedian sagittal TMQLB

Experimental group

Description:

Patients in this group will receive the transmuscular quadratus lumborum block before surgery using the para-sagittal scan, in-plain, caudal to cephalic approach.0.6ml 0.375% ropivocaine was injected when the correct needle location is confirmed.

Treatment:

Procedure: paramedian sagittal scan, in-plane, caudal-cranial TMQLB