The Role of Quadratus Lumborum Blocks Following Minimally Invasive Hysterectomy

The University of Texas Health Science Center, Houston76 enrolled

Overview

The purpose of this study is to compare quality of recovery as well as peri-operative systemic opiates use and pain scores in patients undergoing laparoscopic or robotic hysterectomy when local anesthetic versus Quadratus Lumborum nerve block (QL-2) is added to the standard pain management.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

TRIPLE

Enrollment

Conditions

Pain, Postoperative

Interventions

Local anesthesia at incision siteDRUG

20 ml of 0.25% Bupivacaine will be given at incision site

Sham QLDRUG

20 mls of normal saline given at QL.The QL block will be administered on both the right and left sides. The transducer is placed transverse immediately cranial to the iliac crest and at the level of the posterior axillary line. The needle is then inserted inplane from the lateral edge of the transducer and advanced through the quadratus lumborum (QL) muscle until the needle tip penetrated the epimysium of the anterior part of the QL muscle. The anesthetic is injected after repeated negative aspiration tests for blood in the fascial interspace between the QL and psoas major (PM) muscles posterior to the transversalis fascia

Sham LocalDRUG

Eligibility

Sex: FEMALEMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * English or Spanish speaking * American Society of Anesthesiologists (ASA) physical status 1-3 * Planned laparoscopic or robotic hysterectomy Exclusion Criteria: * History of chronic pain requiring preoperative opioids, Known alcoholism disorder * Congenital coagulopathy, * Localized soft tissue infection, * Use of anticoagulants, * Dementia, inability or refusal to provide consent for the surgery * Morbid obesity (BMI \> 50), due to expected technical difficulty to achieve the block

Locations (1)

The University of Texas Health Science Center at Houston

Houston, Texas, United States

Outcomes

Primary Outcomes

Pain as Assessed by the Quality of Recovery (QOR-40) Validated Questionnaire

The QOR-40 questionnaire has 7 questions assessing pain with a maximum score of 35 and a minimum score of 5, a lower score indicating greater pain.

Time frame: 24 hours after anesthesia

Physical Comfort as Assessed by the Quality of Recovery (QOR-40) Validated Questionnaire

The QOR-40 questionnaire has 12 questions assessing physical comfort with a maximum score of 60 and a minimum score of 12, a lower score indicating a worst outcome.

Time frame: 24 hours after anesthesia

Physical Independence as Assessed by the Quality of Recovery (QOR-40) Validated Questionnaire

The QOR-40 questionnaire has 5 questions assessing physical independence, with a maximum score of 25 and a minimum score of 5, with a lower score indicating a worst outcome.

Time frame: 24 hours after anesthesia

Psychological Support as Assessed by the Quality of Recovery (QOR-40) Validated Questionnaire

The QOR-40 questionnaire has 7 questions assessing Psychological support, with a maximum score of 35 and a minimum score of 7, with a lower score indicating a worst outcome.

Time frame: 24 hours after anesthesia

Emotional State as Assessed by the Quality of Recovery (QOR-40) Validated Questionnaire

The QOR-40 questionnaire has 9 questions assessing emotional state, with a maximum score of 45 and a minimum score of 9, with a lower number indicating a worst outcome.

Time frame: 24 hours after anesthesia

Quality of Recovery as Assessed by the Quality of Recovery (QOR-40) Validated Questionnaire

The QOR-40 questionnaire has 40 questions with a total score from 40 (poorest quality of recovery) to 200 (best quality of recovery), with a higher score indicating a better outcome

Data from ClinicalTrials.gov

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