Quadratus Lumborum Block for Percutaneous Nephrostomy (QLB)

National Cancer Institute, Egypt

Status and phase: Withdrawn; Phase 4

Conditions: Adverse Anesthesia Outcome; Regional Anesthesia Morbidity; Nephrostomy; Complications; Upper Urinary Tract Dilatation and Obstruction

Treatments: Procedure: Local Anesthetic infiltration; Drug: MAC; Procedure: Quadratus Lumborum block

Study type: Interventional

Funder types: Other

Identifiers

NCT02121951

Quadratus Lumborum Block

Details and patient eligibility

About

Percutaneous nephrostomy (PCN) is one of the interventions in the radiology department in which pain control is necessary. Quadratus Lumborum (QL) block will be tried to limit the use of systemic analgesics and its accompanying untoward effects in those frail patients requiring PCN that is performed in the prone position.

Full description

Quadratus Lumborum block is a novel technique in which extension into the thoracic paravertebral space may occur. QL block would seem to be able to alleviate both somatic and visceral pain so it's expected to decrease the need for systemic sedation\analgesia to a minimum.

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. ASA grade III and IV patients,
2. Ureteral obstruction due to malignancy or secondary to urinary diversion after cystectomy

Exclusion criteria

1. Bleeding diathesis; INR more than than 1.5 and platelet count less than 100,000/mm3.
2. Untreated urinary tract infection;
3. Pre-operative haemoglobin <10 gm/dl,
4. Severely co morbid patients
5. Non-dilated renal collecting system
6. Patient refusal to consent for the procedure.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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0 participants in 2 patient groups

Local Anesthetic infiltration and MAC

Active Comparator group

Description:

* Local Anesthetic infiltration with 1% lignocaine * MAC with IV Midazolam Img\\ml and Fentanyl 10 mic\\ml

Treatment:

Drug: MAC

Procedure: Local Anesthetic infiltration

Quadratus Lumborum block and MAC

Experimental group

Description:

* QL block with 0.25% levobupivacaine (Chirocaine, Abbott, Ireland) and 1% lignocaine * MAC with IV Midazolam Img\\ml and Fentanyl 10 mic\\ml

Treatment:

Procedure: Quadratus Lumborum block

Drug: MAC