The Comparison Of Nerve Blocks In Cesarean Delivery

Study Overview
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Brief Summary
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The purpose of this study is to investigate the effect of different kinds of popular peripheral nerve blocks for postoperative analgesia after cesarean delivery is completed, compared with traditional epidual analgesia.

Detailed Description
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Visual Analogue Scale (VAS) and morphine consumption was adopted to evaluate the pain relief.

Official Title
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The Comparison Of Different Nerve Blocks For Postoperative Analgesia In Cesarean Delivery: A Randomized Controlled Trial

Conditions
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Anesthesia, Obstetrical

Intervention / Treatment
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* Procedure: QLB
* Procedure: Intravenous patient controlled analgesia (PCA)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American Society of Anesthesiologists (ASA) physical status I or II weight from 50 to 70 kilogrammes a normal singleton pregnancy ≥37 weeks gestation Exclusion Criteria: congenital coagulopathy anatomic abnormalities localized skin infection allergy to any of the drugs used

Ages Eligible for Study
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Minimum Age: 24 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

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
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: QLB type 2<br>Ultrasound-guided, Inject at the point posterior to quadratus lumborum muscle, 0.2% ropivacaine 30mL in each side for a total of 60mL. Subjects also receive an intravenous patient controlled analgesia (PCA) pump of 0.5 mg/mL morphine for 48 hours. | Procedure: QLB<br>* QLB, quadratus lumborum block.<br>Procedure: Intravenous patient controlled analgesia (PCA)<br>* Intravenous patient controlled analgesia (PCA) pump was used to supply additional analgesia and removed 48 h post-operationally.<br>|
| Experimental: QLB type 3<br>Ultrasound-guided, Inject at the point between the quadratus lumborum and the psoas major muscle, 0.2% ropivacaine 30mL in each side for a total of 60mL. Subjects also receive an intravenous patient controlled analgesia (PCA) pump of 0.5 mg/mL morphine for 48 hours. | Procedure: QLB<br>* QLB, quadratus lumborum block.<br>Procedure: Intravenous patient controlled analgesia (PCA)<br>* Intravenous patient controlled analgesia (PCA) pump was used to supply additional analgesia and removed 48 h post-operationally.<br>|
| Experimental: QLB type 2+3<br>Ultrasound-guided, conduct both QLB type 2 and 3, 0.2% ropivacaine 15mL in each point of injection, for a total of 60mL. Subjects also receive an intravenous patient controlled analgesia (PCA) pump of 0.5 mg/mL morphine for 48 hours. | Procedure: QLB<br>* QLB, quadratus lumborum block.<br>Procedure: Intravenous patient controlled analgesia (PCA)<br>* Intravenous patient controlled analgesia (PCA) pump was used to supply additional analgesia and removed 48 h post-operationally.<br>|
| Active Comparator: epidural anesthesia group (EA)<br>Epidural catheter placement was conducted when finishing spinal anesthesia. After surgery, 30 mL saline (placebo) was Injected at the point posterior to the quadratus lumborum in each side for a total of 60mL. We used a single bolus of 0.15% ropivacaine + 2 mg morphine (diluted in 6 ml saline) via epidural cathether. Subjects also receive an intravenous patient controlled analgesia (PCA) pump of 0.5 mg/mL morphine for 48 hours. | Procedure: QLB<br>* QLB, quadratus lumborum block.<br>Procedure: Intravenous patient controlled analgesia (PCA)<br>* Intravenous patient controlled analgesia (PCA) pump was used to supply additional analgesia and removed 48 h post-operationally.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the change trend of Visual Analogue Scale (VAS) at rest and movement | The purpose is to view the change of the level of pain assessed by subjects at adjacent time points. We would set 0, 4, 6, 12, 24, 48 hours postoperatively as observational time points. | 0-48 hours postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| total morphine consumption | total morphine consumption | 0-48 hours postoperatively | 
| complications | nausea, vomiting, retention of urine, lower limb weakness, etc. | 0-48 hours postoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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quadratus lumborum block, anesthesia, pain, postoperative