Comparison of Ultrasound-guided Quadratus Lumborum Block and Iliohypogastric/Ilioinguinal Nerve Block for Postoperative Pain Management in Patients Undergoing Cesarean Section

Study Overview
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Brief Summary
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The purpose of this study is to compare the analgesic effect of ultrasound-guided quadratus lumborum block and iliohypogastric/ilioinguinal nerve block for postoperative pain management in patients undergoing cesarean section.

Official Title
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Comparison of Ultrasound-guided Quadratus Lumborum Block and Iliohypogastric/Ilioinguinal Nerve Block for Postoperative Pain Management in Patients Undergoing Cesarean Section: a Randomized Double-blind Clinical Trial Study

Conditions
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Quadratus Lumborum Block, Iliohypogastric/Ilioinguinal Nerve Block, Cesarean Section

Intervention / Treatment
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* Procedure: quadratus lumborum block
* Procedure: iliohypogastric/ilioinguinal nerve block
* Procedure: epidural analgesia


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: singleton pregnancy gestation of at least 37 weeks American Society of Anesthesiologists (ASA) physical status I or II finish Pfannenstiel section under combined spinal and epidural anesthesia Exclusion Criteria: pruritus existed before the surgery allergic to lidocaine, ropivacaine or dexamethasone

Ages Eligible for Study
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Minimum Age: 18 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
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: quadratus lumborum block<br>Parturients receive ultrasound-guided quadratus lumborum block as post-operative analgesia. | Procedure: quadratus lumborum block<br>* Quadratus lumborum block is an effective nerve block method in post-cesarean section analgesia. It is a relatively new technique that may provide analgesic effect in somatic pain and visceral pain, but has not been verified yet.<br>|
| Experimental: iliohypogastric/ilioinguinal nerve block<br>Parturients receive ultrasound-guided iliohypogastric/ilioinguinal nerve block as post-operative analgesia. | Procedure: iliohypogastric/ilioinguinal nerve block<br>* Iliohypogastric/ilioinguinal nerve block is a widely used nerve block technique. It can provide somatic analgesia effect in post-cesarean section.<br>|
| Active Comparator: epidural analgesia<br>Parturients receive epidural morphine via epidural catheter placed during anesthesia as post-operative analgesia. | Procedure: epidural analgesia<br>* Epidural analgesia is a traditional analgesia method. Epidural morphine can provide effective analgesia but may cause plenty adverse effect.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| morphine consumption | Every parturient use a patient-controlled intravenous analgesia pump as supplement for the interventions. The analgesia pump contains morphine and can record morphine consumption. Postoperative use of morphine can reflect analgesic effect. | 24 hours postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| morphine consumption | Every parturient use a patient-controlled intravenous analgesia pump as supplement for the interventions. The analgesia pump contains morphine and can record morphine consumption. Postoperative use of morphine can reflect analgesic effect. | 6 hours postoperatively | 
| morphine consumption | Every parturient use a patient-controlled intravenous analgesia pump as supplement for the interventions. The analgesia pump contains morphine and can record morphine consumption. Postoperative use of morphine can reflect analgesic effect. | 12 hours postoperatively | 
| morphine consumption | Every parturient use a patient-controlled intravenous analgesia pump as supplement for the interventions. The analgesia pump contains morphine and can record morphine consumption. Postoperative use of morphine can reflect analgesic effect. | 48 hours postoperatively | 
| pain score | Use visual analogue scale (VAS) 0-10 to evaluate pain intensity and reflect analgesic effect. 0 refers to completely no pain, 10 refers to the most severe pain she has experienced. | 6 hours postoperatively | 
| pain score | Use visual analogue scale (VAS) 0-10 to evaluate pain intensity and reflect analgesic effect. 0 refers to completely no pain, 10 refers to the most severe pain she has experienced. | 12 hours postoperatively | 
| pain score | Use visual analogue scale (VAS) 0-10 to evaluate pain intensity and reflect analgesic effect. 0 refers to completely no pain, 10 refers to the most severe pain she has experienced. | 24 hours postoperatively | 
| pain score | Use visual analogue scale (VAS) 0-10 to evaluate pain intensity and reflect analgesic effect. 0 refers to completely no pain, 10 refers to the most severe pain she has experienced. | 48 hours postoperatively | 
| effective analgesia time | Time period between finish the intervention and the first time parturient use the patient-controlled intravenous analgesia pump for analgesia supplement. | 48 hours postoperatively | 
| adverse effect | Nausea and vomiting, pruritus, oversedation, respiratory depression and urinary retention are considered adverse effects. The incidence and severity are recorded, 1 score refers to mild, 2 scores refers to moderate, 3 scores refers to severe and treatment needed. | 6 hours postoperatively | 
| adverse effect | Nausea and vomiting, pruritus, oversedation, respiratory depression and urinary retention are considered adverse effects. The incidence and severity are recorded, 1 score refers to mild, 2 scores refers to moderate, 3 scores refers to severe and treatment needed. | 12 hours postoperatively | 
| adverse effect | Nausea and vomiting, pruritus, oversedation, respiratory depression and urinary retention are considered adverse effects. The incidence and severity are recorded, 1 score refers to mild, 2 scores refers to moderate, 3 scores refers to severe and treatment needed. | 24 hours postoperatively | 
| adverse effect | Nausea and vomiting, pruritus, oversedation, respiratory depression and urinary retention are considered adverse effects. The incidence and severity are recorded, 1 score refers to mild, 2 scores refers to moderate, 3 scores refers to severe and treatment needed. | 48 hours postoperatively | 
| satisfaction score | Ask the patient to evaluate satisfaction score using 0-10. 0 refers totally dissatisfied, 10 refers to the most satisfied | 48 hours postoperatively | 
| hospital stay | The hospitalize length | at discharge assessed up to 10 days | 
| hospitalize cost | Total cost in this hospitalization | at discharge assessed up to 10 days |