Comparison of Quadratus Lumborum Block Types in Open Gynecologic Surgery

Ankara Etlik City Hospital68 enrolled

Overview

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.

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.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Acute Pain Management Gynecologic Surgical Procedures Quadratus Lumborum Block

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

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

Locations (1)

Ankara Etlik City Hospital

Ankara, Ankara, Turkey (Türkiye)

Outcomes

Primary Outcomes

Reduction of opioid requirement in patients undergoing open myomectomy and total abdominal hysterectomy

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.

Time frame: from april to may

Secondary Outcomes

no need for additional analgesia

the first postoperative analgesic consumption in patients undergoing open myomectomy and total abdominal hysterectomy.

Time frame: from 1 may to 15 may

Data from ClinicalTrials.gov

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