Quadratus Lumborum Block Type III Versus Type II Versus Transversus Abdominis Plane Block in Cesarean Section

The General Authority for Teaching Hospitals and Institutes

Status: Completed

Conditions: Cesarean Section; Quadratus Lumborum Block; Transversus Abdominis Plane Block

Treatments: Procedure: Quadratus lumborum block III; Procedure: Quadratus lumborum block typen II; Procedure: Transversus abdominis plane block

Study type: Interventional

Funder types: NETWORK

Identifiers

NCT05950568

HB000132

Details and patient eligibility

About

Compare the type III and type II quadratus lumborum block (QLB) to transversus abdominis plane block (TAPB) regarding efficacy in CS

Full description

The transversus abdominis plane block (TAPB) is administered between the internal oblique muscle and the transversus abdominis muscle in the fascial plane, directly pointing to the somatic nerves T6-L1 that run in this plane. In addition, meta-analyses demonstrate that it is an effective analgesic for somatic pain and diminishes opiate intake. It has been reported that TAPB is an efficient analgesic approach following cesarean section .

The quadratus lumborum (QL) muscle block (QLB) is a fascial plane block as local anesthetic (LA) is introduced nearby to the QL muscle to numb the thoracolumbar nerves. QLB is categorized into four types according to drug administration location, I (lateral), II (posterior), III (anterior/transmuscular), and Intravenous, (intramuscular). QLB can effectively decrease both visceral and somatic pain by LA distribution to the thoracic paravertebral space (TPVS), as this block ensures effective pain control from the T7 to L1 dermatomes. QLB is one of the regional techniques that provides the greatest benefit in post-CS pain control, as it is progressively applied in obstetric anesthetic precise to improve analgesic results.

Enrollment: 60 patients

Sex: Female

Ages: 18 to 40 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiologists (ASA) physical status II
• aged 18 to 40 years old
• presenting for elective Cesarean section

Exclusion criteria

• body mass index (BMI) ≥40 kg/m2
• weight < 50kg
• height < 150 cm
• contraindications for the use of active labor, spinal anesthesia
• recent opiate intake
• hypersensitivity to any used medication
• substantial cardiovascular diseases
• renal diseases
• hepatic, diseases.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 3 patient groups

Quadratus lumborum block type II

Active Comparator group

Description:

A 22 gauge needle was positioned between the erector spinae muscle in the thoracolumbar fascia's middle layer

Treatment:

Procedure: Quadratus lumborum block typen II

Quadratus lumborum block type III

Active Comparator group

Description:

A 22 gauge needle was positioned between the psoas and quadratus lumborum muscles at the anterior fascia lumbosacral

Treatment:

Procedure: Quadratus lumborum block III

Transversus abdominis plane block

Active Comparator group

Description:

A 22 gauge needle was positioned between the internal oblique and transversus abdominis muscles

Treatment:

Procedure: Transversus abdominis plane block