TQLB for elective caesarean delivery
Research type
Research Study
Full title
A randomized controlled trial evaluating the effect of transmuscular quadratus lumborum block on maternal analgesic and recovery outcomes following elective caesarean delivery
IRAS ID
241086
Contact name
Sohail Bampoe
Contact email
Sponsor organisation
University College London (UCL)
Clinicaltrials.gov Identifier
Z6364106/2019/01/106, UCL Data Protection Ref No.
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Caesarean delivery is the most commonly performed operation worldwide. Currently the gold standard pain relief for caesarean delivery is spinal anaesthesia (drug administered into the spinal fluid), containing local anaesthetic and a long acting opioid drug called diamorphine. Increasing the dose of diamorphine improves duration of pain relief after caesarean delivery, however it also increases the chance of undesirable side-effects such as nausea, vomiting and itching. Caesarean delivery is a painful operation, and women frequently have postoperative pain requiring intravenous or oral morphine, which can slow recovery and delay hospital discharge. Women undergoing caesarean delivery in some countries (such as the Unites States) are discharged home with these strong painkillers. We wish to find better methods of providing pain relief after caesarean delivery to avoid undesirable side-effects and reduce hospital length of stay.
A new regional anaesthetic technique was described in 2013 called the transmuscular quadratus lumborum block (TQLB). This involves 2 ultrasound-guided local anaesthetic injections on each side of the abdomen after surgery. Patients are still numb at this point due to on-going effects of the spinal anaesthetic, so they do not feel any discomfort from the block. By numbing the wound site for longer, when the spinal drugs wear off, patients should remain pain free for longer. This technique has not yet been explored in caesarean delivery patients.
We will randomly allocate women to receive either: (1) current standard care (spinal anaesthetic with diamorphine and regular / as required painkillers following surgery) or (2) standard care and TQLB at the end of caesarean delivery. The blocks will be performed by experienced anaesthetists who specialise in regional anaesthesia. Patients will then be followed up by the research team postoperatively in order to assess need for morphine, pain scores, nausea, vomiting, satisfaction and overall quality of recovery.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
19/LO/0330
Date of REC Opinion
2 Jul 2019
REC opinion
Further Information Favourable Opinion