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Comparison of Intrathecal Morphine With the Quadratus Lumborum Type 2 Block for Post-operative Analgesia Following Elective Caesarean Section (QLBvITM Study)

15 april 2019 uppdaterad av: Dr Willem Basson

Quadratus Lumborum Type 2 Block Versus Intrathecal Morphine for Analgesia Following Elective Caesarean Sections

The investigators are comparing post operative analgesia provided for caesarean section patients, with the quadratus lumborum type 2 block and intrathecal morphine.

Studieöversikt

Status

Indragen

Betingelser

Intervention / Behandling

Detaljerad beskrivning

In Australia the rate of birth via caesarean section (CS) has significantly increased over the last twenty years. Improvements in the care of women undergoing CS are important locally, nationally and internationally. Compared to women birthing vaginally, women undergoing CS experience more adverse events and more pain. Effective pain relief following CS is important as it enables early ambulation, encourages maternal bonding, and promotes breastfeeding initiation and establishment. Traditional analgesic techniques following CS include opioid medications. Whist effective, the use of opioids are associated with frequent and significant side effects. Alternative analgesic agents are being explored in an attempt to improve the effectiveness of pain relief available to women and clinicians.

The quadratus lumborum block (QLB) block is an innovative regional analgesic technique. Its role as an effective analgesic agent in abdominal surgery is increasing. However, it has not been studied for pain relief in Australia after cesarean section.

In this study, the investigator aims to compare post-operative analgesia and side effects between the QLB blocks versus adding morphine the participant's spinal anaesthetic (ITM) during the elective C/S. Results from this study will provide information on the analgesic impact of this new and emerging therapy and assist in the development of a larger clinical trial.

Studietyp

Interventionell

Fas

  • Inte tillämpbar

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 50 år (Vuxen)

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Kvinna

Beskrivning

Inclusion Criteria:

  • Anaesthetist trained in QLB and ITM techniques available
  • American Society of Anaesthesiologists PS category client I or II
  • 18 years of age or older
  • Ability to read and understand English
  • Uncomplicated pregnancy at term (>37 weeks completed gestation)
  • Booked elective CS

Exclusion Criteria:

  • Contraindications to spinal anaesthesia
  • History of chronic opioid consumption / chronic pain conditions
  • Known allergy to study drugs
  • Weight more than 95kg or body mass index (BMI) more than 35 pre operative
  • Placenta Previa / accreta
  • Obstructive Sleep apnoea
  • Severe asthma unable to tolerate Non steroidal anti inflammatory agents

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Stödjande vård
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Fyrdubbla

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Sham Comparator: Saline intrathecal as well as saline in Blocks
These 25 patients will receive 0.3ml saline added to the spinal anaesthetic and 25 ml saline both sides as a QLB2.
Procedur: Saline intrathecal as well as saline in Blocks
0.3 ml saline will be added to the spinal anaesthetic. 25 ml saline will be used on each side during a quadratus lumborum type 2 block.
Procedur: Saline intrathecal as well as local anaesthetic in Blocks
0.3 ml saline will be added to the spinal anaesthetic. A Quadratus lumborum type 2 block will be performed under ultrasound with 25 ml 0.375% ropivacaine deposited posterior to the quadratus lumborum muscle.
Aktiv komparator: Saline intrathecal as well as local anaesthetic in Blocks
These 25 patients will receive 0.3ml saline added to the spinal anaesthetic and 25 ml local anaesthetic both sides as a QLB2.
Procedur: Saline intrathecal as well as saline in Blocks
0.3 ml saline will be added to the spinal anaesthetic. 25 ml saline will be used on each side during a quadratus lumborum type 2 block.
Procedur: Intrathecal morphine as well as local anaesthetic in Blocks
A Quadratus lumborum type 2 block will be performed under ultrasound with 25 ml 0.375% ropivacaine deposited posterior to the quadratus lumborum muscle. 150mcg morphine will be added to the spinal anaesthetic.
Aktiv komparator: Intrathecal morphine as well as local anaesthetic in Blocks
These 25 patients will receive 0.3ml (150mcg) morphine added to the spinal anaesthetic and 25 ml local anaesthetic both sides as a QLB2.
Procedur: Intrathecal morphine as well as local anaesthetic in Blocks
A Quadratus lumborum type 2 block will be performed under ultrasound with 25 ml 0.375% ropivacaine deposited posterior to the quadratus lumborum muscle. 150mcg morphine will be added to the spinal anaesthetic.
Procedur: Intrathecal morphine as well as saline in Block
150mcg morphine will be added to the spinal anaesthetic. 25 ml saline will be used on each side during a quadratus lumborum type 2 block.
Aktiv komparator: Intrathecal morphine as well as saline in Block
These 25 patients will receive 0.3ml (150mcg) morphine added to the spinal anaesthetic and 25 ml saline both sides as a QLB2.
Procedur: Saline intrathecal as well as local anaesthetic in Blocks
0.3 ml saline will be added to the spinal anaesthetic. A Quadratus lumborum type 2 block will be performed under ultrasound with 25 ml 0.375% ropivacaine deposited posterior to the quadratus lumborum muscle.
Procedur: Intrathecal morphine as well as saline in Block
150mcg morphine will be added to the spinal anaesthetic. 25 ml saline will be used on each side during a quadratus lumborum type 2 block.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
24 hours total intravenous morphine usage via a PCA pump
Tidsram: 24 hours
Post operative intravenous morphine use will be noted at 24 hours post cesarean section
24 hours

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Patient's side effects within the 24 hours post operative period.
Tidsram: 24 hours
Nausea, vomiting, itching, herpes reactivation, urinary retention and sedation will be noted.
24 hours
Pain Scores within 24 hours post operative period.
Tidsram: 24 hours
Using a VAS we will note both dynamic and static pain scores at 24 hours post operative
24 hours

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Dr Willem Basson

Samarbetspartners

Sunshine Coast Hospital and Health Service

Utredare

  • Huvudutredare: Willem Basson, FANZCA, Sunshine Coast University Hospital

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Förväntat)

1 januari 2019

Primärt slutförande (Förväntat)

1 november 2019

Avslutad studie (Förväntat)

31 december 2019

Studieregistreringsdatum

Först inskickad

10 augusti 2017

Först inskickad som uppfyllde QC-kriterierna

28 augusti 2017

Första postat (Faktisk)

30 augusti 2017

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

17 april 2019

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

15 april 2019

Senast verifierad

1 april 2019

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • HREC/17/QPCH/121

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

Kliniska prövningar på Smärta, Akut

Kliniska prövningar på Saline intrathecal as well as saline in Blocks

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