- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03110081
Comparing the Efficacy of Epidural and Quadratus Lumborum Analgesia After Open Nephrectomy Surgery (QL Analgesia)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
QL blocks with a single shot and catheters infusions may be an alternative to epidural analgesia. However, the relative efficacy, safety, and cost of the two approaches remain unclear.
Epidural analgesia is frequently used as a component of multimodal analgesia for thoracic and abdominal surgery. QL block has been introduced recently as a component of multimodal analgesia for lower thoracic and abdominal surgery. In general, insertion of QL catheter is easier and safer than insertion of epidural catheters. QL catheter management is also less complicated than epidural analgesia (fewer catheter displacements and less hemodynamic compromise) and decreases the level of complexity in postoperative care. Our hypothesis is that the subcostal QL approach with a continuous catheter is non-inferior to epidural analgesia for pain control and opioid consumption in patients having open partial nephrectomy procedure.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Ohio
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Cleveland, Ohio, United States, 44195
- Cleveland Clinic Foundation
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Adults having for open unilateral partial nephrectomy surgery.
Exclusion Criteria:
1. Pregnancy 2. Intolerance or allergy to opioids 3. Previous radical nephrectomy surgery/midline incision 4. Contraindication to epidural analgesia 5. Contraindications to QL block 6. Chronic pain characterized by: i.Opioids use for more than 30 consecutive days within the 3 preoperative months at the dose equal or greater than equivalent of 15 mg of morphine ii.Abdominal pain for more than 6 months, present most days of the week-
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Quadratus lumborum block
Quadratus lumborum (QL) block group will receive a single shot injection of 25 ml 0.25% bupivacaine pre-operatively, followed post-operatively by infusion of ropivacaine 0.2% continuously administered via the QL catheter for at least 48 hours.
|
Quadratus lumborum (QL) block for open partial nephrectomy.
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Active Comparator: Epidural analgesia
Midthoracic catheters will be inserted preoperatively.
A bupivacaine 0.1% infusion will be started before the surgical incision, and continuously administered for at least 48 hr at an infusion rate of 5 ml/hr.
|
Epidural analgesia for open partial nephrectomy.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Total opioid consumption
Time Frame: Arrival to post anesthesia care unit until 72 hours after surgery
|
Total IV morphine-equivalent doses used, started postoperatively at the time of arrival to post anesthesia care unit until 72 hours after surgery.
|
Arrival to post anesthesia care unit until 72 hours after surgery
|
Postoperative pain
Time Frame: Arrival to post anesthesia care unit until 72 hours after surgery
|
Time-weighted average verbal rating scale for pain until 72 hours after operation as a time-weighted average, based on nursing assessments at four-hour intervals.
The verbal rating scale ranges from 0 to 10, with 0 indicating no pain and 10 indicating worst pain imaginable.
Time-weighted average pain is defined as the sum of each time interval between two adjacent pain score measurements multiplied by the average of the two corresponding pain scores divided by the time interval between the first and last pain scores.
|
Arrival to post anesthesia care unit until 72 hours after surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patient Global Assessment
Time Frame: Three days after surgery
|
Patient global assessment of pain control is measured on an ordinal scale by the patient.
Patients can rate their pain control as poor, fair, good, or excellent.
|
Three days after surgery
|
Doses of antiemetic medications administered
Time Frame: Arrival to post anesthesia care unit until the third day after surgery
|
Count of the number of antiemetic medications administered.
|
Arrival to post anesthesia care unit until the third day after surgery
|
Duration of postoperative hospitalization
Time Frame: From the date of surgery to hospital discharge, assessed up to 12 months.
|
Duration of postoperative hospitalization
|
From the date of surgery to hospital discharge, assessed up to 12 months.
|
Episodes of hypotension
Time Frame: Arrival to post anesthesia care unit until the third day after surgery
|
Number of episodes of hypotension during hospital stay, defined by MAP less than 65 mmHg requiring intervention.
|
Arrival to post anesthesia care unit until the third day after surgery
|
Collaborators and Investigators
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 15-1291
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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