Quadratus Lumborum Block Versus Erector Spinae Plane Block in Extracorporeal Shock Wave Lithotripsy(ESWL)

South Valley University

Status: Completed

Conditions: Lithiasis; Pain

Treatments: Procedure: Erector spinae plane block; Procedure: Quadratus lumborum block type III

Study type: Interventional

Funder types: Other

Identifiers

NCT05937256

Regional blocks in ESWL

Details and patient eligibility

About

This study is designed to compare analgesic effect of both the ultrasound (US)-guided QLB and ESPB blocks during ESWL and their effect on stone fragmentation.

Full description

Urinary tract calculi, one of the most common benign urological diseases, is seen in 12% of patients and has a recurrence rate of approximately 50%.

Management of renal calculi is known to be affected by many factors, specially tolerance of pain during ESWL and how it is controlled.

Pain experienced during ESWL is thought to occur when shock waves from the lithotripter reach superficial structures such as skin and also deeper structures such as the ribs, nerves and the kidney capsule. There are three main factors that contribute to the propagation of pain at these structures: shock wave (SW) pressure, distribution, and focal area size .

Conventionally, pain during ESWL is managed by basic analgesics such as NSAIDs, which can also aid in stone clearance. Other methods of analgesia also have been studied and tested.

Quadratus lumborum block (QLB) was first described by Blanco in 2007, it blocks T7-L1 nerve fibres in most of the cases. Studies have reported its use in the management of postoperative pain after hip surgeries.

"Erector Spinae Plane Block" (ESPB) is another such block, that is increasingly tried for the management of postoperative pain for breast surgery, thoracic surgery, and also upper abdominal surgeries. ESPB when given at the lumbar region gives blockade from C7-T2 to L2-L3.

Enrollment: 90 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Informed written consent obtained
• Age 18-60
• Both sex
• American Society of Anesthesiologists(ASA) physical status: I, II
• Stone pelvis less than 2.5 cm
• Indicated for ESWL

Exclusion criteria

• refusal of participation by parents or caregivers.
• ASA physical status: > II
• Stone pelvis >2.5 cm
• Chronic pain
• On chronic NSAID or opioid
• Substance addict
• Known local anesthetic drug sensitivity.
• Preexisting infection at block site
• Coagulopathy or anticoagulation.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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90 participants in 3 patient groups

Group Q

Active Comparator group

Description:

(n=30) will receive unilateral quadratus lumborum block type III

Treatment:

Procedure: Quadratus lumborum block type III

Group E

Active Comparator group

Description:

(n=30) will receive unilateral erector spinae plane block

Treatment:

Procedure: Erector spinae plane block

Group C

No Intervention group

Description:

(n=30) will be control group receiving no intervention, managed only with conventional analgesia