Transmuscular Quadratus Lumborum Block Hip Surgery
Conditions
Brief summary
a novel approach for TQL (anterior Q.L) block aiming mainly for terminal branches of lumbar plexus. The technique is described as Para-Spinous Saggital Shift Q.L block, done at L4 transverse process level in saggital orientation.
Detailed description
With this approach, we think it has advantages of easy identification, better caudal LA spread till under fascia iliaca, with the psoas major muscle provides a better protective barrier against accidental needle entry into the peritoneal cavity, the endpoint is injection within a fascial plane, rather than a specific motor response contact where the lumbar plexus stimulation is not sought, so there is minimal risk of nerve injury, inadvertent dural cuff puncture and intrathecal spread of local anesthetic. And finally optimal insertion of catheter in long axis of Q.L and psoas major if continuous analgesia is planned.
Interventions
transmuscular quadratus lumborum block as an alternative to lumbar plexus block for peri-operative analgesia in hip Surgery
Sponsors
Alexandria University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
* Orthopaedic patients, American Society of Anesthesiologists (ASA) physical status I-III, scheduled to undergo unilateral hip surgery.
Exclusion criteria
* History of neurological/neuromuscular, psychiatric disease, dementia preventing proper comprehension. * Patients with Body Mass Index (BMI) \<18.5 or \>30 kg/m2. * Coagulation disturbances (INR\>1.4, platelet count\<100 000). * History of opioid dependence (opioid use within the last 4 weeks). * History of allergies to study medications.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| peri-operative analgesia in hip Surgery | one month | post-operative VAS score |
Countries
Egypt
Outcome results
None listed