Quadratus Lumborum Block for Post-Cesarean Analgesia

• Status: Terminated
• Trial end date: 2017-02-05
• Target enrollment: 0
• Participant gender: Female

Summary

Most women having planned cesarean section receive spinal anesthetic for the procedure.

Typically, spinal opioids are administered during the same time as a component of multimodal analgesia to provide pain relief in the 16-24 hr period postoperatively. However, spinal opioids are frequently associated with adverse effects such as nausea, pruritus, sedation and occasionally respiratory depression.

The quadratus lumborum (QL) block is a regional analgesic technique which blocks T5-L1 nerve branches and has an evolving role in postoperative analgesia for lower abdominal surgeries and is a potential alternative to spinal opioids. There is some evidence that it may provide visceral along with somatic pain relief. It is a simple and safe technique that has been studied in lower abdominal surgeries, but has not been studied for pain relief after cesarean section.

If found effective, it will have the advantage of a reduction in opioid associated adverse effects while providing similar quality of analgesia. This block has evolved from the previously known transversus abdominis plane block.

We propose to undertake a study that will compare the relative efficacy of QL block with local anesthetic to spinal morphine. We will also study if it provides any incremental benefit when administered in addition to spinal morphine.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Lawson Health Research Institute
• Treatments: Anesthetics; Morphine; Ropivacaine

Criteria

Inclusion Criteria:

• Elective cesarean delivery

• American Society of Anesthesiologists Physical Status 1-3

• Suitable for procedure to be carried out under spinal anesthesia

Exclusion Criteria:

• Inability to give informed consent or to co-operate with post-operative evaluation

• Allergy to local anesthetics, morphine, fentanyl, ropivacaine

• Ongoing major medical or psychiatric problems

• Chronic opioid use

• Major coagulopathy

• BMI>35 on first ante natal visit

• Pre-eclampsia

• Contraindication to neuraxial anesthesia