Pain Postoperative
Conditions
Keywords
Transmuscular quadratus lumborum block, total abdominal hysterectomy
Brief summary
Patients who have undergone laparotomies often require multimodal postoperative pain regimes. In recent years, abdominal wall blocks have been included to become part of this in order to overcome side effects of systemic opioids and complications from epidural analgesia. Borglum popularised a new approach on abdominal wall blocks by introducing the transmuscular quadratus lumborum (QL) block. Transmuscular QL block is thought to be effective against somatic and visceral pain as local anaesthetic tends to spread from the site of injection to thoracic paravertebral spaces where the sympathetic chain lies. The objective of this study is to evaluate the analgesic efficacy of transmuscular QL block in patients undergoing total abdominal hysterectomy (TAH) by measuring cumulative opioid consumption, pain score at rest and on movement 24 hours after TAH. Our hypothesis is patients given transmuscular QL block will have lower cumulative opioid consumption.
Interventions
Sponsors
Kuala Lumpur General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
1. ASA I or II 2. Patient's weight \> 50kg 3. Elective TAH
Exclusion criteria
1. Body mass index (BMI) \> 35 kg/m2 2. Any contraindications to peripheral nerve blocks i.e. local skin infection, coagulopathy, allergy to LA 3. Inability to use patient controlled analgesia 4. Patient on antiplatelet, anticoagulant or on regular use of opioids, paracetamol, nonsteroidal anti-inflammatory drugs or tramadol for chronic condition
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cumulative morphine consumption | 24 hours after total abdominal hysterectomy | in mg for 24 hours |
| Pain score at rest and movement | 24 hours after total abdominal hysterectomy | using visual analogue scale 1 to 10 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Complications related to the transmuscular QL block | 24 hours after total abdominal hysterectomy | Complications related to transmuscular QL block: Haematoma at site of injection,infection at site of injection Complications related to PCAM:Nausea, vomiting, pruritus, sedation |
Countries
Malaysia
Outcome results
None listed