Post-operative Analgesia Efficacy Using Ultrasound-guided Transmuscular Quadratus Lumborum Block Versus Ultrasound-guided Quadratus Lumborum Type II Block.

Study Overview
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Brief Summary
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Post-operative analgesia efficacy using ultrasound-guided transmuscular quadratus lumborum block versus ultrasound-guided quadratus lumborum type II block

Detailed Description
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The Quadratus Lumborum (QL) Block is an ultrasound-guided technique described by Rafael Blanco in 2007. The nerves to the lower abdominal wall can be anesthetized by injecting local anesthetics between the quadratus lumborum muscle and latissimus dorsi muscle, which is called quadratus lumborum type II block. 〝 Transmuscular quadratus lumborum block demonstrates that injectate spreads over the posterior abdominal wall to the psoas major muscle and includes the upper branches of the lumbar plexus.〞described by Adhikary in 2016. However there are no published reports comparing the 2 techniques. In our study, compared of ultrasound-guided QL2-blocks with transmuscular quadratus lumborum block to investigate analgesic consumption, pain level, opioid related side effects and mobilization.

Official Title
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Post-operative Analgesia Efficacy Using Ultrasound-guided Transmuscular Quadratus Lumborum Block Versus Ultrasound-guided Quadratus Lumborum Type II Block.

Conditions
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Nerve Block

Intervention / Treatment
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* Drug: Bupivacaine
* Device: Ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American Society of Anesthesiologists classification (ASA) 1 3 adequate communication skills Body mass index < 32 Exclusion Criteria: chronic pain neurological illness/ neuropathy contraindication against local anesthetics

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 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: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: 3 group: Group A: without intervention; Group B: Ultrasound-guided transmuscular quadratus lumborum block; Group C: Ultrasound-guided quadratus lumborum type II block
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Group A<br>without nerve block | |
| Active Comparator: Group B<br>Ultrasound guided transmuscular quadratus lumborum block with 0.125% bupivacaine 30ml | Drug: Bupivacaine<br>* injecting anesthetics to different local<br>* Other names: Marcaine;Device: Ultrasound<br>* Ultrasound guided nerve block<br>* Other names: Philp;|
| Active Comparator: Group C<br>Ultrasound guided quadratus lumborum type 2 block with 0.125% bupivacaine 30ml | Drug: Bupivacaine<br>* injecting anesthetics to different local<br>* Other names: Marcaine;Device: Ultrasound<br>* Ultrasound guided nerve block<br>* Other names: Philp;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| morphine consumption | morphine consumption | 48 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Severity of postoperative pain via visual analogue pain scale (VAS) | Total cumulative morphine dose in mg used in the first 48 hours after surgery | 48 hours | 
| Nausea or vomiting | Severity of nausea or vomiting in the first 48 hours after surgery. Severe :3 Moderate:2 Mild:1 None: 0 | 48 hours | 
| time to mobilization | Time to mobile in the first 48 hours after surgery | 48 hours | 
| Skin itch | Severity of skin itch in the first 48 hours after surgery. Severe :3 Moderate:2 Mild:1 None: 0 | 48 hours |