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Trial registered on ANZCTR
Registration number
ACTRN12624001031550
Ethics application status
Approved
Date submitted
16/06/2024
Date registered
27/08/2024
Date last updated
5/10/2024
Date data sharing statement initially provided
27/08/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Quadratus Lumborum Block for Postoperative Pain in Transurethral Resection of Bladder Tumors
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Scientific title
The Effect of Ultrasound-Guided Anterior and Posterior Quadratus Lumborum Blocks on Postoperative Pain Management in Patients Undergoing Transurethral Resection of Bladder Tumor
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Secondary ID [1]
312307
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
postoperative pain management
334056
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bladder tumor
334335
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Condition category
Condition code
Anaesthesiology
330725
330725
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0
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Pain management
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Anaesthesiology
330726
330726
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0
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Anaesthetics
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Renal and Urogenital
330989
330989
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0
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Other renal and urogenital disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
In this study, 105 patients undergoing elective transurethral bladder tumor resection under spinal anesthesia will be randomly assigned to 3 groups. Group A will be received ultrasound-guided anterior quadratus lumborum block (QLB) where the local anesthetic is injected anterior to the QL muscle with 0.25% 20 mL bupivacaine each side and group B will be received ultrasound-guided posterior QLB where the local anesthetic is injected posterior to the QL muscle with 0.25% 20 mL bupivacaine each side by one of two experienced anesthesiologists who will not participate in the rest of the study. Group C will be received a placebo. Local anesthetic doses are determined by the anesthesiologist performing the procedure in accordance with clinical studies in the literature. All injection procedures will be performed once as soon as the surgery is completed. Patients will be monitored by the nurse and doctor in the 24-hour period after the procedure and the parameters will be noted for evaluation. The block procedures mentioned above and postoperative pain monitoring are routine procedures, and medical records will be reviewed in the study. The investigator will not be involved in patient care, preoperative evaluation, or data collection but will use a random sequence of numbers to randomize patients.
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Intervention code [1]
328780
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Treatment: Other
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Comparator / control treatment
In the control group (group C) will be received bilateral sham ultrasound-guided QLB via an injection of 1 mL of normal saline after surgery.
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Control group
Placebo
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Outcomes
Primary outcome [1]
338484
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time to first analgesic request
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Assessment method [1]
338484
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assessed by data linkage to medical records, the first bolus dose will be administered to patients with a Visual Analogue Scale (VAS) > 3 with the patient controlled analgesia (PCA) device. The time is defined as an interval between end of local anesthetic injection and first pressing time of analgesic pump from 0 to 24 hours after the surgery.
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Timepoint [1]
338484
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24 hours after the surgery
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Primary outcome [2]
338485
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total opioid consumption
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Assessment method [2]
338485
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assessed by data linkage to medical records, total number of intravenous patient controlled analgesia (PCA) requests and actual tramadol doses delivered to the patient in 24 hours after the surgery
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Timepoint [2]
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24 hours after the surgery
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Secondary outcome [1]
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postoperative side effects
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Assessment method [1]
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assessed by data linkage to medical records, the incidence of side effects within the 24 hours postoperative monitoring period, including pruritus, nausea and vomiting, hypotension, shivering, bradycardia, respiratory depression will be recorded
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Timepoint [1]
436112
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24 hours after the surgery
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Secondary outcome [2]
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additional analgesic requirement
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Assessment method [2]
436247
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assessed by data linkage to medical records, total number of using rescue analgesics besides PCA
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Timepoint [2]
436247
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24 hours after the surgery
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Eligibility
Key inclusion criteria
Patients who are aged between 20 to 75 years with a body mass index (BMI) of 20-30 kg/m2, who are included in the American Society of Anesthesiologists Physical Status I-II-III classes will be scheduled elective transurethral bladder tumor resection under spinal anesthesia.
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Minimum age
20
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients with coagulation abnormalities, local anesthetic allergy, systemic or puncture site infections, alcohol and drug addictions, inability to accurately cooperate in pain assessments due to cognitive dysfunction, liver or kidney failure and persistent pain more than 3 months will be excluded from the study.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
numbered containers
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation procedure such as coin-tossing will be used.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/09/2024
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Actual
1/09/2024
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Date of last participant enrolment
Anticipated
1/07/2025
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Actual
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Date of last data collection
Anticipated
1/09/2025
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Actual
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Sample size
Target
105
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Accrual to date
10
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Final
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Recruitment outside Australia
Country [1]
26374
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Turkey
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State/province [1]
26374
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Istanbul
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Funding & Sponsors
Funding source category [1]
316700
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Self funded/Unfunded
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Name [1]
316700
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unfunded
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Address [1]
316700
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Country [1]
316700
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Primary sponsor type
Hospital
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Name
Health Sciences Istanbul Training and Research Hospital
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Address
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Country
Turkey
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Secondary sponsor category [1]
318902
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None
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Name [1]
318902
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Address [1]
318902
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Country [1]
318902
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
315480
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Bezmialem Vakif University Clinical Research Ethics Committee
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Ethics committee address [1]
315480
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+90 (212) 523 22 88
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Ethics committee country [1]
315480
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Turkey
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Date submitted for ethics approval [1]
315480
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10/07/2024
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Approval date [1]
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26/08/2024
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Ethics approval number [1]
315480
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2024-KAEK-03
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Summary
Brief summary
Multimodal analgesia aims to reduce the side effects of each treatment modality while providing effective and comprehensive pain management by targeting various mechanisms of pain. Fascial plane blocks, whose application frequency has been increasing recently; It plays an important role in postoperative analgesia by ensuring direct and specific optimization of pain control, less opioid use and reduction of opioid-related side effects (e.g. nausea, vomiting, respiratory depression). The effects of the quadratus lumborum block, which is one of the fascial plane blocks and is known to provide effective analgesia after surgical procedures, especially in the lower abdomen and pelvis, are open to research due to its different approaches and application methods. Quadratus lumborum block provides effective analgesia in TUR-M cases, reducing postoperative opioid consumption. Anterior quadratus lumborum block may be a better choice than the posterior approach as it may spread more and faster to the paravertebral area.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
134822
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Dr Iremgul Nalbat
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Address
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Kasap Ilyas Mah. Org Nafiz Gurman Cd. Istanbul Training and Research Hospital (Istanbul Egitim ve Arastirma Hastanesi) Yogun Bakim Klinigi
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Country
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Turkey
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Phone
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+905303899471
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Fax
134822
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Email
134822
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[email protected]
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Contact person for public queries
Name
134823
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Iremgul Nalbat
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Address
134823
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Kasap Ilyas Mah. Org Nafiz Gurman Cd. Istanbul Training and Research Hospital (Istanbul Egitim ve Arastirma Hastanesi) Yogun Bakim Klinigi
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Country
134823
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Turkey
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Phone
134823
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+905303899471
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Fax
134823
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Email
134823
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[email protected]
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Contact person for scientific queries
Name
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Iremgul Nalbat
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Address
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Kasap Ilyas Mah. Org Nafiz Gurman Cd. Istanbul Training and Research Hospital (Istanbul Egitim ve Arastirma Hastanesi) Yogun Bakim Klinigi
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Country
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Turkey
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Phone
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+905303899471
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Fax
134824
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
24222
Ethical approval
387941-(Uploaded-30-09-2024-16-55-55)-12-9. 2024-52 (Sorumlu Arastirmaci Veysel ERDEN).pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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