Quadratus Lumborum Block Reduced Postpartum Uterine Pain After Virginal Childbirth

Study Overview
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Brief Summary
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With the continuous advancement of ultrasonic technology, nerve block in which drugs are injected into the periphery of the target nerve through ultrasonic guidance has become the mainstream method for postoperative pain control. The quadratus lumborum nerve block has been effectively and safely used in abdominal surgery (such as laparotomy, caesarean section, etc.), effectively reducing postoperative wounds and visceral pain. There is no research on the use of quadratus lumborum nerve block to control the pain of natural postpartum uterine contractions in the current literature, so the purpose of this experiment is to explore whether the quadratus lumborum nerve block can effectively reduce the pain of uterine contractions after vaginal delivery.

Official Title
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Quadratus Lumborum Block Reduced Postpartum Uterine Pain After Virginal Childbirth

Conditions
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Vaginal Delivery, Quadratus Lumborum Nerve Block, Postpartum Cramping

Intervention / Treatment
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* Procedure: quadratus lumborum nerve block (ropivacaine )
* Procedure: quadratus lumborum nerve block (normal saline)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Females over twenty years of age Maternal vaginal delivery Postpartum moderate to severe pain with uterine contractions (Numerical Pain Scale (NRS) ≥ 4 points) after delivery. Subject's consent signed by the subject Exclusion Criteria: Severe coagulation abnormalities (PLT<100000、INR>1.2、PT>13) Infection of the epidermis at the anticipated relevant site of injection Allergy to local anesthetics Allergy to or abuse of pain control medications Episiotomy is more painful than uterine contractions Inability to cooperate with associated pain assessment Body Mass Index (BMI) ≧ 35 kg/m2

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Fifty subjects were randomly assigned to the quadratus lumborum nerve block group with injection of local anesthetic (Ropivacaine), and another 50 subjects were assigned to the quadratus lumborum nerve block with normal saline injection. The total number of subjects involved is one hundred.
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: quadratus lumborum nerve block group with injection of local anesthetic (Ropivacaine)<br>The subjects would have quadratus lumborum nerve block group with injection of local anesthetic (Ropivacaine) after vaginal delivery. | Procedure: quadratus lumborum nerve block (ropivacaine )<br>* Echo guided quadratus lumborum nerve block with ropivacaine<br>* Other names: QLB;|
| Placebo Comparator: quadratus lumborum nerve block with normal saline<br>The subjects would have quadratus lumborum nerve block with normal saline after vaginal delivery. | Procedure: quadratus lumborum nerve block (normal saline)<br>* Echo guided quadratus lumborum nerve block with normal saline<br>* Other names: QLB;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain associated with uterine contractions | Grading with Numerical Pain Scale [0 (no pain at all) to 10 (worst imaginable pain)] and Visual Analogue Scale [mark a position between 0 (no pain at all) to 10 (worst imaginable pain)] | Right before intervention | 
| Pain associated with uterine contractions | Grading with Numerical Pain Scale [0 (no pain at all) to 10 (worst imaginable pain)] and Visual Analogue Scale [mark a position between 0 (no pain at all) to 10 (worst imaginable pain)] | 1 hour after intervention | 
| Pain associated with uterine contractions | Grading with Numerical Pain Scale [0 (no pain at all) to 10 (worst imaginable pain)] and Visual Analogue Scale [mark a position between 0 (no pain at all) to 10 (worst imaginable pain)] | 6 hours after intervention | 
| Pain associated with uterine contractions | Grading with Numerical Pain Scale [0 (no pain at all) to 10 (worst imaginable pain)] and Visual Analogue Scale [mark a position between 0 (no pain at all) to 10 (worst imaginable pain)] | 12 hours after intervention | 
| Pain associated with uterine contractions | Grading with Numerical Pain Scale [0 (no pain at all) to 10 (worst imaginable pain)] and Visual Analogue Scale [mark a position between 0 (no pain at all) to 10 (worst imaginable pain)] | 24 hours after intervention | 
| Pain associated with uterine contractions | Grading with Numerical Pain Scale [0 (no pain at all) to 10 (worst imaginable pain)] and Visual Analogue Scale [mark a position between 0 (no pain at all) to 10 (worst imaginable pain)] | 36 hours after intervention | 
| Pain associated with uterine contractions | Grading with Numerical Pain Scale [0 (no pain at all) to 10 (worst imaginable pain)] and Visual Analogue Scale [mark a position between 0 (no pain at all) to 10 (worst imaginable pain)] | 48 hours after intervention |