Oblique Subcostal Transversus Abdominis Plane Block Versus Transmuscular Quadratus Lumborum Block for Pain Management in Laparoscopic Gynecological Surgery

Bursa Uludag University

Status: Completed

Conditions: Postoperative Pain; Surgery

Treatments: Procedure: Transmuscular Quadratus Lumborum Block; Procedure: Oblique Subcostal Transversus Abdominis Plane Block

Study type: Interventional

Funder types: Other

Identifiers

NCT06017401

UludagU-KCebeci-001

Details and patient eligibility

About

Laparoscopic gynecological surgery causes postoperative pain.The primary objective of this study is to compare the effect of ultrasound (US)-guided oblique subcostal transversus abdominis plane block (OSTAP) on 24-hour total analgesic consumption with transmuscular quadratus lumborum block (TQLB).

Full description

Patients between the ages of 18-65, who will undergo laparoscopic gynecological surgery, American Society of Anesthesiologists (ASA) class I-II-III, Body Mass Index (BMI) in the range of 18-25 kg/m², and who will use 3 or 4 trocar for surgery will be included in the study. Patients will be randomized into two groups. OSTAP block will be performed for OSTAPB group and TQL block will be performed for TQLB group. Patients will be administered postoperative 4x500 mg iv paracetamol as needed (if Visual Analogue Scale (VAS) score is 4 or higher). If the VAS score remains at 4 or higher 30 minutes after paracetamol administration, 1 mg/kg iv tramadol will be administered as a rescue analgesic (with a daily maximum dose of 400 mg). The primary outcome is to compare the total analgesic consumption within the first 24 hours after surgery. The secondary outcome is to compare the time to the first postoperative analgesic requirement, VAS scores at rest and on movement, and assess the impact of these two blocks on the quality of recovery using the QOR-15 scale

Enrollment: 68 patients

Sex: Female

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Ages of 18-65
• Patients who will undergo laparoscopic gynecological surgery
• ASA I-II-III patients
• Body Mass Index (BMI) in the range of 18-25 kg/m²
• Patients who will undergo surgery using 3 or 4 trocars

Exclusion criteria

• ASA IV-V
• Patients with a known or suspected allergy to local anesthetics
• Coagulopathy
• Injection site infection
• Severe neurological or psychiatric disorders
• Severe cardiovascular disease
• Liver failure
• Kidney failure (glomerular filtration rate <15 ml/min/m²)
• Chronic opioid use (>6 months)
• Surgical durations less than 45 minutes or greater than 120 minutes

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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68 participants in 2 patient groups

Group OSTAP

Active Comparator group

Description:

The investigator will perform oblique subcostal transversus abdominis plane block to that patient group for postoperative analgesia

Treatment:

Procedure: Oblique Subcostal Transversus Abdominis Plane Block

Group TQLB

Active Comparator group

Description:

The investigator will perform transmuscular quadratus lumborum block to that patient group for postoperative analgesia

Treatment:

Procedure: Transmuscular Quadratus Lumborum Block