Efficacy of Corticoid Infiltration in Quadratus Lumborum Syndrome

January 21, 2018 updated by: Hospital de Braga

Evaluation of Triamcinolone's Efficacy on the Ultrasound- Guided Infiltration in the Quadratus Lumborum Syndrome: a Double Blind, Randomized, Controlled Study

This study has the primary goal of evaluating the efficacy of corticoid infiltration in the quadratus lumborum syndrome, aiming to determine if there are benefits with the use of corticosteroids and if they exist, if this improvement comes only from the systemic effects of corticosteroid administration.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

This study has the primary goal of evaluating triamcinolone's efficacy on the ultrasound- guided infiltration in the quadratus lumborum syndrome, aiming to determine if there are benefits with the use of corticosteroids and if they exist, if this improvement comes only from the systemic effects of corticosteroid administration.

It is an interventional study, double-blinded and randomized, in a sample of patients followed in the Chronic Pain Unit (Hospital of Braga, Portugal), proposed for ultrasound infiltration of the quadratus lumborum muscle.

The selection of the patients will take into account the inclusion and exclusion criteria, until reach the required sample size (66 patients). The confirmation of the inclusion criteria will be done by a physiatrist blind to randomization.

Different protocols will be randomly applied to patients after obtaining written informed consent.

The techniques will be performed by two anesthetists. The data will be obtained through questionnaires filled out on the day of the technique and in the course of 1, 3 and 6 months in chronic pain consultation and by telephone call 72 hours after the procedure. It will be a psychologist, blind to randomization, to fill the questionnaires.

Patients will be also evaluated in consultation, at the same time, the course of 1, 3 and 6 months.

After the data collection it will be performed a statistical analysis.

Study Type

Interventional

Enrollment (Anticipated)

66

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Portugal
    • Minho
      • Braga, Minho, Portugal, 4710-243
        • Hospital of Braga

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 75 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

I) patients followed in the Chronic Pain Unit proposed to have ultrasound- guided infiltration of the quadratus lumborum muscle.

II) written informed consent.

III) presence of 4 of the following clinical criteria evaluated by a physiatrist:

  • pain below the 12th rib and 5 cm lateral to the transverse process of L1 during palpation, with referred pain to the iliac crest;
  • pain on palpation of the trigger points in the quadratus lumborum muscle;
  • exacerbation of the pain with with postural changes when lying down, walking, sitting and/or squatting;
  • lumbar pain with muscle stretching;
  • painful palpation of trigger points at the level of L4 vertebral body, 1 to 2 cm above the iliac crest.

Exclusion Criteria:

  • rheumatologic disease;
  • psychiatric disease;
  • neurological disease;
  • history of anticoagulation use;
  • pregnant patients;
  • uncontrolled diabetes mellitus;
  • patients on corticosteroid therapy;
  • allergy to the medication to be used;
  • anterior realization of ultrasound techniques for low back pain ;
  • anterior realization, of invasive techniques, less than 6 months, with administration of medication.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Quadratus triamcinolone
Quadratus lumborum muscle and fascia infiltration with 40mg of triamcinolone and 10ml of levobupivacaine 0,25%.
Drug: Quadratus triamcinolone
40mg of triamcinolone and 10ml of levobupivacaine 0,25%.
Other Names:
  • Quadratus lumborum infiltration with triamcinolone.
Experimental: Gluteus triamcinolone
Gluteus maximus and fascia infiltration with 40mg of triamcinolone and 10ml of levobupivacaine 0,25%.
Drug: Gluteus triamcinolone
40mg of triamcinolone and 10ml of levobupivacaine 0,25%.
Other Names:
  • gluteus maximus infiltration with triamcinolone.
Active Comparator: Quadratus without triamcinolone
Quadratus lumborum muscle and fascia infiltration with 10ml of levobupivacaine 0,25%.
Drug: quadratus without triamcinolone.
10ml of levobupivacaine 0,25%.
Other Names:
  • quadratus lumborum infiltration without triamcinolone.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Efficacy of intervention.
Time Frame: 3 months after intervention.
Evaluation of pain score using numerical rating scale (NRS), represented 0 with no pain and 10 with the worst pain imaginable. It will be evaluated the actual, average and worst intensity of pain. Efficacy of the procedure will be defined as greater or equal to 30% pain relief lasting at least 3 months.
3 months after intervention.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain evaluation
Time Frame: 6 months after intervention.
Evaluation of pain score using numerical rating scale (NRS), represented 0 with no pain and 10 with the worst pain imaginable. It will be evaluated the actual, average and worst intensity of pain.
6 months after intervention.
Quality of life.
Time Frame: 6 months after intervention.
The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability.
6 months after intervention.
Psychological status.
Time Frame: 6 months after intervention.

To assess the level of anxiety and depression it will be used the HADS scale (Hospital Anxiety and Depression Scale).

The HADS anxiety and depression subscales each consist of 7 items, and each item is rated on a 4-point scale; potential scores for each subscale range from 0 to 21. Patients with scores ≥8 on each subscale are considered symptomatic with general anxiety or depressive symptoms.
6 months after intervention.
Complications and adverse effects caused by the intervention.
Time Frame: 72 hours after intervention.
It will be asked to the patients for any adverse effect or complication including pain, hematoma, allergic reaction, paresthesias and decreased muscle strength.
72 hours after intervention.
Opioid consumption.
Time Frame: 6 months after intervention.
Opioid intake will be converted in morphine equivalence in mg.
6 months after intervention.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Hospital de Braga

Collaborators

University of Minho

Investigators

  • Principal Investigator: Ana Cunha, MD, Hospital of Braga, Braga, Minho, Portugal, 4710-243

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 1, 2017

Primary Completion (Anticipated)

April 30, 2019

Study Completion (Anticipated)

November 1, 2019

Study Registration Dates

First Submitted

October 12, 2017

First Submitted That Met QC Criteria

January 21, 2018

First Posted (Actual)

January 23, 2018

Study Record Updates

Last Update Posted (Actual)

January 23, 2018

Last Update Submitted That Met QC Criteria

January 21, 2018

Last Verified

January 1, 2018

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CESHB 019/2016

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Undecided

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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