Clinical trial NCT06451354: Postoperative Analgesia After Cesarean Section; Comparison Among Ultrasound Guided Erector Spinae, Quadratus Lumborum or Transversus Abdominis Plane Blocks
Official title: Postoperative Analgesia After Cesarean Section; Comparison Among Ultrasound Guided Erector Spinae, Quadratus Lumborum or Transversus Abdominis Plane Blocks: A Prospective Randomized Study
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Postoperative Analgesia
Cesarean Section
Erector Spinae Block
Quadratus Lumborum Block
Transversus Abdominis Plane Block
Lead sponsor: Kafrelsheikh University
Sponsor class: OTHER
First posted: 2024-06-11
Enrollment: 140
Sex: FEMALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: The aim of this prospective randomized controlled study is to compare the analgesic efficacy of the ultrasound-guided erector spinae plane block, ultrasound-guided quadratus lumborum plane block, and ultrasound-guided transversus abdominis plane block in patients undergoing elective cesarean section.

Detailed description: Acute postpartum pain is a key determinant of maternal satisfaction; may lead to persistent postoperative pain.

Opioids are used to control severe pain. However, they have many common side effects as sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression.

Transversus abdominis plane (TAP) block is a regional injection of local anesthetic between the transversus abdominis and internal oblique muscle planes. TAP block affects the sensory nerves of the anterolateral abdominal wall (T6-L1) that innervate the abdomen. TAP block is an easy technique, and decreases postoperative pain and opioid consumption.

Erector Spinae Plane block (ESPB), first described for analgesia in thoracic neuropathic pain has also been reported for the management of other causes of acute postoperative pain.

Quadratus Lumborum block (QLB) differ from the transversus abdominis plane block (TAP) it is a block of the posterior abdominal wall. It is also referred to as an inter fascial plane block because it requires the injection of a local anesthetic into the thoracolumbar fascia (TLF).

Eligibility criteria: Inclusion Criteria:

* Age ≥ 18 years.
* American Society of Anesthesiologists (ASA) classification II.
* Female patients scheduled for elective cesarean section under spinal anesthesia.

Exclusion Criteria:

* Patient refusal.
* Patients who are taking analgesics for chronic illness or have history of substance abuse.
* Patients who are unable to describe their postoperative pain (e.g., language barrier or neuropsychiatric disorder).
* Patients with a history of coagulopathy.
* Patients weight less than 60 kilograms.
* Patient height less than 150 cm.
* Patients with known local anesthetics and opioid allergy.
* Patients with infection at the site of the needle puncture.
* Patients with major respiratory, cardiac, renal, or hepatic disorders.

Primary outcomes:
measure: Postoperative morphine consumption
timeFrame: 24 hours postoperatively
Secondary outcomes:
measure: Degree of pain
timeFrame: 24 hours postoperatively
measure: Time for first request of the rescue analgesia
timeFrame: 24 hours postoperatively
measure: Complications
timeFrame: 24 hours postoperatively
measure: Degree of patient satisfaction
timeFrame: 24 hours postoperatively
Other outcomes:
Locations:
city: Kafr Ash Shaykh
country: Egypt
facility: Kafrelsheikh University
state: Kafrelsheikh
Study officials:
References: