Analgesia of Erector Spinae Plane Block Versus Quadratus Lumborum Block

Summary

Colorectal cancer is the third most common cancer worldwide. These patients usually undergo open surgical resection of cancer under general anaesthesia.

The aim of this study is to detect whether the Erector spinae plan block or Quadratus lumborum block will provide the most ideal analgesia for these patients. Erector spinae plan block is a novel analgesic technique that provides both visceral and somatic analgesia due to its communication with the paravertebral space. Quadratus lumborum block is a truncal nerve block usually used for intra-abdominal surgeries. Ultrasound guidance increases the accuracy and safety of both techniques. A local anaesthetic mixture of Bupivacaine 0.25% and dexamethasone will be used for both techniques.

Conditions

• Colorectal Cancer

Interventions

OTHER

Erector spinae plane block

For each side, the eighth thoracic transverse process will be identified by a linear US transducer (HFL38\_10-5 MHz), puncture will be performed in the plane in the craniocaudal direction until the needle contacts the transverse process, and 20 ml of bupivacaine 0.25% and 4 mg dexamethasone will be injected visualizing the hydrodissection. After 30 minutes, the degree of sensory block in the trunk will be assessed by the pinprick test and any undesirable motor weakness will be recorded as a side effect.

OTHER

Quadratus lumborum block

For each side, shamrock sign with three leaves (psoas major muscle anteriorly, the erector spinae muscle posteriorly and the quadratus lumborum muscle adherent to the apex of the transverse process of the L4 vertebral body) will be identified by a curved array US transducer (6-2MHz), puncture will be performed in-plane, the needle will be advanced through the quadratus lumborum muscle penetrating the ventral proper fascia of the quadratus lumborum muscle, and 20 mL of bupivacaine 0.25% and 4 mg dexamethasone will be injected in that space visualizing the hydrodissection. After 30 minutes, the degree of sensory block in the trunk will be assessed by the pinprick test and any undesired motor weakness will be recorded as a side effect

DRUG

Propofol

Propofol (2 mg/kg)

DRUG

Fentanyl NCS

Fentanyl (1µg/Kg)

DRUG

Atracurium Injectable Product

atracurium (0.5mg/kg)

OTHER

Endotracheal intubation

endotracheal intubation

DRUG

Anesthesia Maintenance

Inhalational isoflurane in oxygen/air mixture

DRUG

Muscle Relaxation

atracurium boluses (0.2 mg/Kg/20 minutes) will be used for maintenance of general anesthesia

Sponsors & Collaborators

• Mansoura University

  lead OTHER

Principal Investigators

• Amer A Attieh, MD · Professor

• Mohammed A Ghanem, MD · Associate Professor

Study Design

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

40 Years

Max Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-05-01

Primary Completion

2020-01-01

Completion

2020-04-01

Countries

• Egypt

Study Locations