Acute Pain Management, Gynecologic Surgical Procedures, Quadratus Lumborum Block
Conditions
Keywords
quadratus lumborum block, open gynecological operations, acute pain
Brief summary
This study was conducted to evaluate the effectiveness of Quadratus Lumborum Type 1 and Type 2 blocks on postoperative acute pain in gynecological operations performed with a Pfannenstiel incision.
Detailed description
This prospective observational study was conducted to observe and analyze postoperative acute pain outcomes in patients undergoing open gynecologic surgery with a Pfannenstiel incision. The study included patients who received quadratus lumborum block (QLB) techniques as part of routine perioperative analgesic management. Quadratus lumborum blocks were performed using ultrasound guidance according to standard clinical practice. The block was administered with the patient in the lateral position, and a high-frequency linear ultrasound transducer was used to identify the quadratus lumborum muscle and surrounding anatomical structures. For Quadratus Lumborum Type 1 (lateral) block, local anesthetic was injected at the anterolateral border of the quadratus lumborum muscle. For Quadratus Lumborum Type 2 (posterior) block, local anesthetic was deposited posterior to the quadratus lumborum muscle, within the thoracolumbar fascial plane. The selection of Quadratus Lumborum Type 1 or Type 2 block was determined solely by the attending anesthesiologist based on routine clinical considerations, surgical characteristics, and patient-related factors. No intervention or regional analgesia technique was assigned by the investigators for the purpose of this study, and study participation did not influence anesthetic management. Participants would have received the same anesthetic and regional analgesia techniques in the same manner and intensity regardless of study enrollment. Postoperative acute pain outcomes were prospectively collected and analyzed between predefined exposure groups according to the routinely applied quadratus lumborum block technique. The investigators did not modify clinical practice, dosing, timing, or performance of regional anesthesia. All anesthetic and analgesic interventions were provided as part of standard medical care. This study was approved by the local ethics committee as an observational study and was conducted in accordance with institutional standards of care.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
* ASA I-III * Female patients aged 18-80 * Cases undergoing open myomectomy and total abdominal hysterectomy
Exclusion criteria
* Those who do not want a block * Patients who are allergic to local anesthetics * Patients with coagulopathy * Pregnancy * Previous surgery in the area where the block will be applied
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Reduction of opioid requirement in patients undergoing open myomectomy and total abdominal hysterectomy | from april to may | It investigates the effectiveness of quadratus lumborum 1 block alone in acute pain, compared to quadratus lumborum 1 and 2 blocks applied together in patients undergoing open myomectomy and total abdominal hysterectomy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| no need for additional analgesia | from 1 may to 15 may | the first postoperative analgesic consumption in patients undergoing open myomectomy and total abdominal hysterectomy. |
Countries
Turkey (Türkiye)
Contacts
ANKARA ETLİK CİTY HOSPİTAL