TAP vs QLB in Patients After Cesarean Delivery

Medical University of Lublin

Status and phase: Completed; Phase 4

Conditions: Postoperative Pain; Cesarean Section

Treatments: Drug: Ropivacaine; Procedure: QL (quadratus lumborum block); Device: Needle; Drug: Ketoprofen; Drug: paracetamol; Drug: Morphine; Procedure: TAP (transversus abdominis plane block); Drug: metamizole

Study type: Interventional

Funder types: Other

Identifiers

NCT03404908

KE-0254/238/2017

Details and patient eligibility

About

Comparison of two types of analgesia after cesarean section All patients will be anesthetized with spinal technique. Ultrasound-guided transversus abdominis plane or quadratus lumborum block to treat postoperative pain. Postoperative pain will be measured with visual-analog scale (VAS). 1, 2, 6 months after surgery each patient will be called to assess neuropathic pain with Neuropathic Pain Symptom Inventory (NPSI).

Full description

Written consent will be obtained before the cesarean section. Only subarachnoidally anesthetized patients may participate in the study. Pencil-point spinal needle and bupivacaine (Marcaine Heavy Spinal 0.5 %) will be used.

At the end of surgery ultrasound-guided regional block will be performed. Each patient will be randomly allocated to one of the treated group: transversus abdominis plane block (TAP) or quadratus lumborum (QL). Patients receive 0.2 mL of local anesthetic solution (0.375 % ropivacaine) on each side.

Postoperative pain will be measured with VAS (visual-analog scale) 2, 4, 8, 12 and 24 hours after the end of the operation.

Paracetamol, metamizole, ketoprofen may be given as required. Whenever pain exceeds 40 (VAS) 5 mg of morphine will be given intravenously (maximum two dosages per day).

1, 3, 6 months patients will be called to assess neuropathic pain. Neuropathic Pain Symptom Inventory (NPSI) will be used.

Enrollment: 105 patients

Sex: Female

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• obtained consent
• singleton pregnancy
• subarachnoid anesthesia

Exclusion criteria

• coagulopathy
• allergy to local anesthetics
• depression, antidepressant drugs treatment
• epilepsy
• usage of painkiller before surgery
• addiction to alcohol or recreational drugs

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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105 participants in 2 patient groups

TAP

Experimental group

Description:

Ultrasound-guided transversus abdominis plane block at the end of cesarean section

Treatment:

Drug: Morphine

Device: Needle

Procedure: TAP (transversus abdominis plane block)

Drug: Ropivacaine

Drug: paracetamol

Drug: Ketoprofen

Drug: metamizole

QLB

Experimental group

Description:

Ultrasound-guided quadratus lumborum block at the end of cesarean section

Treatment:

Drug: Morphine

Device: Needle

Drug: Ropivacaine

Procedure: QL (quadratus lumborum block)

Drug: paracetamol

Drug: Ketoprofen

Drug: metamizole