Clinical trial NCT03545295: Determination Of Dispersion In Ultrasound Guided Quadratus Lumborum Block In Cadavers
Official title: Determination Of The Relationship Between Local Anesthetic Volume And Its Dispersion In Ultrasound Guided Quadratus Lumborum Block In Cadavers
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Nerve Block
Lead sponsor: Federal University of São Paulo
Sponsor class: OTHER
Collaborators: name: Irmandade da Santa Casa de Misericordia de Sao Paulo
First posted: 2018-06-04
Enrollment: 20
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: the cadavers will be randomized to receive the intervention (Quadratus Lumborum Block) by different techniques (QLB 2/ QLB3) and different volumes (10, 20, 30 ml)
Primary purpose: TREATMENT

Brief summary: Lumbar Quadrant Blockade is a recent analgesic technique consisting of the injection of local anesthetic around the lumbar square muscle. It was initially described as a technique for abdominal wall analgesia, but later studies have increased the range of indications for laparoscopic and lower limb surgeries. There are several techniques described but with differences in the literature at the point of injection and volume of anesthetic. The exact mechanism of visceral analgesia has not yet been determined. The objective of this study is to determine the dispersion of local anesthetic as a variable dependent on the volume of local anesthetic and injection site and elucidate the mechanisms of analgesia.

Detailed description: After the free and informed consent signed by the family authorizing the procedure, demographic and clinical data will be collected from the medical records of the deceased. The corpse will be weighed, measured and placed on the autopsy table. Blockade randomization (QLB 2 or QLB 3) and volume of local anesthetic (10ml, 20ml, 30ml) will be performed for each side. Injection in the anterior or posterior plane to the Lumbar Quadrant muscle will be performed by anesthesiologists experienced in the technique with ultrasound aid. A colouring solution will be used. After confirming the correct needle position, the previously randomized volumes will be injected. After the blockage, the corpse will be placed in the supine position and will be submitted to autopsy by standard procedure. After removal of the thoracic and abdominal viscera, the investigators will verify the dispersion of the local anesthetic. Photographic records will be made and the number of levels by which the solution dispersed will be annotated, calculating the number of cranial and caudal levels. The corpse will then have its autopsy procedure completed, with the placement of the viscera and incision closure according to the service standard.

Eligibility criteria: Inclusion Criteria:

* Fresh corpses - not subjected to a formaldehyde process or frozen for more than 24 hours
* Age ≥ 18 years.
* Free, informed and informed consent signed by relatives or guardians of the body.
* Height\> 150 cm and \<190 cm

Exclusion Criteria:

* Previous spinal surgery.
* Significant spinal deformity
* Body mass index (BMI) ≥ 35 kg / m2
* Absence of relatives or guardians who can sign the written consent

Primary outcomes:
measure: Spread of coloring solution according to the volume injected
timeFrame: 3 hours
Secondary outcomes:
measure: Spread of coloring solution to the paravertebral space
timeFrame: 3 hours
measure: Comparison of spread of the coloring solution between QLB 2 and QLB3
timeFrame: 3 hours
Other outcomes:
Locations:
city: Sao Paulo
country: Brazil
facility: Irmandade de Misericórdia da Santa Casa De São Paulo
state: SP
Study officials:
affiliation: Post Graduate
name: Marilia Tassinari Gonçalves Preza, MD
role: PRINCIPAL_INVESTIGATOR
References:
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