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This study evaluates the postoperative analgesic effects of transversalis fascia plane block and anterior quadratus lumborum block in patients having cesarean section under general anesthesia. General anesthesia will be performed to all patients for the surgery.
In this study, patients are divided into two groups. After the general anesthesia is performed and cesarean section surgery is over; TFPB block will be performed to patients in Group A ; while anterior QLB block will be performed to patients in Group B. In addition, patient controlled analgesia (PCA) will be used in the first 24 hours postoperatively. Group A - Patients in group A will have TFPB block after the surgery. In addition, patient controlled analgesia (PCA) will be used in the first 24 hours postoperatively. Group B - Patients in group B will have anterior QLB block after the surgery. In addition, patient controlled analgesia (PCA) will be used in the first 24 hours postoperatively.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Transversalis Fascia Plane Block | Active Comparator | Transversalis Fascia Plane Block (TFPB) will be performed the patients in Group A after the cesarean section surgery. Patient controlled analgesia device (PCA) is used for all the patients in the first 24 hours postoperatively |
|
| Quadratus Lumborum Block | Active Comparator | Anterior Quadratus Lumborum Block ( Anterior QLB) will be performed the patients in Group B after the cesarean section surgery. Patient controlled analgesia device (PCA) is used for all the patients in the first 24 hours postoperatively |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Regional anesthesia TFPB | Other | Transversalis Fascia Plane Block will be performed with 25 mL of 0.25% bupivacaine,after the end of cesarean surgery before extubation. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Opioid consumption in the first 24 hours after surgery | Morphine consumption in the first 24 hours will be counted by IV patient controlled analgesia device (PCA). Patients will be able to request opioids via PCA device when the nrs score is above 4. | Postoperative Day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Post-operative acute pain | Pain status will be evaluated based on numeric rating scale (NRS) scores at rest and after movement. Pain status will be evaluated at 1, 3, 6, 9, 12, 18, 24. hours after surgery. Each NRS is scores 0-10. (0=no pain ; 10=worst pain imaginable) | Postoperative Day 1 |
| The time of first opioid requirement |
| Measure | Description | Time Frame |
|---|---|---|
| The incidences of post-operative nausea and vomiting (PONV) | the presence of nausea and vomiting will be recorded for 24 hours after surgery | Postoperative Day 1 |
| The incidence of side effects related to local anesthetics, opioid use and regional anesthesia technic |
Inclusion Criteria:
Exclusion Criteria:
Pregnant women planned for elective cesarean operation
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| Name | Affiliation | Role |
|---|---|---|
| Sezgin Bilgin | Ondokuz Mayıs University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ondokuz Mayıs University Faculty of Medicine | Samsun | 55200 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D000377 | Agnosia |
| D059787 | Acute Pain |
| D059350 | Chronic Pain |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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Randomization of the study will be done by a doctor who will not participate in patient follow-up with closed envelopes using computer-generated randomization codes.
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The anesthesia doctor who will perform the interfascial plane block (TFPB, anterior QLB) will be informed with a sealed envelope by an independent assistant outside the study, and the patient will not know which block is performed.
|
| Regional anesthesia QLB | Other | Anterior Quadratus Lumborum Block will be performed with 25 mL of 0.25% bupivacaine, after the end of cesarean surgery before extubation. |
|
|
The time of first opioid requirement will be recorded during the postoperative first 24 hours |
| Postoperative Day 1 |
respiratory depression, local anesthetic (LA) toxicity, hematoma and organ damage. |
| Postoperative Day 1 |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |