Quadratus Lumborum Block by Paraspinous Sagittal Shift Approach With Different Concentrations Of Bupivacaine in Hip Surgeries

Study Overview
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Brief Summary
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The aim of this study is to evaluate the optimum concentration of bupivacaine in Paraspinous Sagittal Shift Approach for Quadratus Lumborum Block in hip Surgeries

Detailed Description
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With the patient in the lateral decubitus and the block side independent, a curvilinear ultrasound transducer (2-5 MHz) will be directed caudally in a sagittal plane 3-4 cm lateral to the lumbar spinous process of L4, which is almost opposite to the iliac crest, producing a longitudinal scan of the lumbar paravertebral region; and thus identifying the transverse processes of L3 and L4, with PM muscle in-between and erector spinae muscle posteriorly. The probe is shifted slowly to the lateral side until the transverse processes disappear and the QL muscle is evident in its long axis attached caudally to the iliac crest with a characteristic sonographic image of three muscle layers appearing from posterior to anterior as: erector spinae, QL, and PM muscles respectively. After subcutaneous local infiltration with lidocaine at the cephalic end of the probe, the block needle is advanced in a cephalo-caudal direction, through the erector spinae and QL muscles, until it pierces the epimysium of the QL. LA is injected anterior to the QL muscle, observing its spread in a caudal direction towards the iliac crest between the QL and psoas muscles

Official Title
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Comparison Of The Analgesic Efficacy Of Quadratus Lumborum Block By Paraspinous Sagittal Shift Approach With Different Concentrations Of Bupivacaine in Hip Surgeries

Conditions
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Hip Surgeries

Intervention / Treatment
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* Other: quadratus lumborum block by paraspinous sagittal shift approach


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA I and II undergoing hip surgery. Exclusion Criteria: Contraindications for regional blocks (eg. Patient refusal Infection at the injection site, coagulopathy) allergic reaction to drugs. opium addiction, any drug or substance abuse

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group 0.25% bupivacaine<br>30 ml 0.25% bupivacaine | Other: quadratus lumborum block by paraspinous sagittal shift approach<br>* quadratus lumborum block by paraspinous sagittal shift approach<br>|
| Active Comparator: Group 0.375% bupivacaine<br>0.375% bupivacaine | Other: quadratus lumborum block by paraspinous sagittal shift approach<br>* quadratus lumborum block by paraspinous sagittal shift approach<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| time to first request of analgesics | Postoperative time to first request of analgesics (hours) | Postoperative 24 hours |