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Renal Transplant Donor of Left KidneyNCT03520205

Quadratus Lumborum Block Versus Epidural for Laparoscopic Nephrectomy Kidney Donor

A study testing Quadratus Lumborum Block and Continuous Epidural in people with Renal Transplant Donor of Left Kidney, run by Universitas Indonesia at 1 site in Indonesia.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study aimed to compare Quadratus Lumborum Block to Epidural on Stress Response and Perioperative Cellular Immunological Function of Laparoscopic Nephrectomy Kidney Donor Read more about this study

Who is it for?
Ages 18 to 60 yearsHealthy volunteers can take part
Conditions the study is for
Renal Transplant Donor of Left Kidney
What is being tested?
Quadratus Lumborum Block and Continuous Epidural
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
62 participants
Where
1 siteIndonesia
Study dates
1 May 2018to 31 Dec 2018
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Kidney donor patients undergoing laparoscopic nephrectomy
  • Body mass index below 30
  • Duration of surgery 4 to 6 hours
  • Patients who agreed to participate in this study and sign informed consent.

Who cannot join

  • Have contraindication for quadratus lumborum block
  • Have contraindication for epidural
  • Previous history of local anesthetic drug allergy
  • inability to communicate

Trial locations and contacts

1 site in 1 country.

Indonesia1 site
  • Cipto Mangunkusumo Central National Hospital

    Jakarta Pusat, DKI Jakarta, 10430

Other trials in Indonesia

About this study

Official title: Comparison Between Quadratus Lumborum Block and Epidural on Stress Response and Perioperative Cellular Immunological Function of Laparoscopic Nephrectomy Kidney Donor

This study aimed to compare Quadratus Lumborum Block to Epidural on Stress Response and Perioperative Cellular Immunological Function of Laparoscopic Nephrectomy Kidney Donor

Read the detailed description

Sixty-two subjects were given informed consent before enrolling the study and randomized into two groups; quadratus lumborum block and epidural. Non-invasive blood pressure monitor, electrocardiogram (ECG), and pulse-oxymetry were set on the subjects in the operation room. General anesthesia induction was done by fentanyl 2 mcg/kg and propofol 1-2 mg/kg. Endotracheal tube (ETT) intubation was facilitated with Atracurium 0.5mg/kg as muscle relaxant. Maintenance was done by sevoflurane, oxygen, and compressed air. On quadratus lumborum block group, bilateral block using ultrasound will be performed with stimuplex 100mm needle with 20 cc of bupivacaine 0.25% as regimen. On epidural group, epidural catheter was inserted under general anaesthesia on left lateral decubitus position (5 cm depth inside the epidural space) at level Th10-Th11. The catheter insertion was confirmed with vacuum aspiration and negative test-dose. Before first incision, patient will be given continuous epidural Bupivacaine 0.25% 6 mL/hour. Blood sample was drawn for interleukin-6, blood glucose, and c-reactive protein as baseline data. After surgery, patient were extubated until fully conscious and can follow command verbally. Patient will be transported in recovery room post operation.

Being tested
Quadratus Lumborum Block, Continuous Epidural
Keywords
stress response, kidney donor, Cellular Imunological Function, quadratus lumborum block, numerical rating scale, morphine patient controlled analgesia
Medical subject headings
Fractures, Stress

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Quadratus Lumborum BlockProcedure or surgery

    Bilateral block using ultrasound will be performed before surgery and after surgery on patient using Stimuplex 100mm needle with Bupivacaine 0.25% 0.4 mL/kg, maximum dose 25 mL each side under general anaesthesia

  • Continuous EpiduralProcedure or surgery

    Patient will be given 6 mL/hour of Bupivacaine 0.25% for intraoperative analgesia and continued epidural 6 mL/hour Bupivacaine 0,125% as postoperative analgesia in 24 hours.

Study groups in NCT03520205
Study groupRoleWhat they receive
Quadratus Lumborum BlockActive comparatorPatient will receive quadratus lumborum block
Receives: Procedure: Quadratus Lumborum Block
Continuous EpiduralActive comparatorPatient will receive epidural anesthesia
Receives: Procedure: Continuous Epidural

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from Baseline Interleukin-6 at 24 hours after abdominal insufflation

    Measure by ELISA

    Measured: Before procedure, at the end of surgery, and 24 hours after abdominal insufflation

  2. Cumulative morphine requirement at 2 hours, 6 hours, 12 hours, 24 hours postoperative

    Cumulative morphine consumption at each time point in 24 hours after surgery

    Measured: 2 hours, 6 hours, 12 hours, 24 hours.

Secondary outcomes (14)
  1. Change from Baseline Patient Controlled Analgesia at 2, 6, 12 and 24 hours after procedure

    Measure by how many times patient use morphine PCA analgesia

    Measured: 2, 6, 12, and 24 hours after procedure

  2. Change from Baseline Pain Intensity at 2, 6, 12, and 24 hours after procedure

    Measured by Numerical Rating Scale

    Measured: 2, 6, 12, and 24 hours after procedure

  3. Change from Baseline Blood Glucose at 2 hours after abdominal insufflation

    Measured by finger-stick blood sample

    Measured: Before procedure and 2 hours after abdominal insufflation

  4. Change from Baseline Blood pressure

    Measured by non-invasive blood pressure monitoring at before anaesthesia induction (baseline), post-induction, gas-insufflation, Pfannenstiel incision, end of surgery, and 24 hours surgery

    Measured: Intraoperative and 24 hours

  5. Change from Baseline Mean Arterial Pressure

    Measured by non-invasive blood pressure monitoring at before anaesthesia induction (baseline), post-induction, gas-insufflation, Pfannenstiel incision, end of surgery, and 24 hours surgery

    Measured: Intraoperative and 24 hours

  6. Change from Baseline Cardiac Index

    Measured by cardiometry ICON® at before anaesthesia induction (baseline), post-induction, gas-insufflation, Pfannenstiel incision, end of surgery, and 24 hours surgery

    Measured: Intraoperative and 24 hours

  7. Change from Baseline Heart Rate

    Measured by pulse oximetry at before anaesthesia induction (baseline), post-induction, gas-insufflation, Pfannenstiel incision, end of surgery, and 24 hours surgery

    Measured: Intraoperative and 24 hours

  8. Change from Baseline hs-CRP at 48 hours after abdominal insufflation

    Measured with ELISA

    Measured: Before procedure, at the end of surgery, and 48 hours after abdominal insufflation

  9. Time to first morphine requirement

    Duration from end of anesthesia until first attempt of morphine requirement in minutes

    Measured: 24 hours

  10. Total bupivacaine used in 24 hours

    Total bupivacaine used until 24 hours postoperatively

    Measured: 24 hours

  11. Change from baseline motor block at 2, 6, 12, and 24 hours after anesthesia recovery

    Measured by Bromage score

    Measured: 2, 6, 12, and 24 hours after procedure

  12. Number of participants with paresthesia after procedure

    in percentage

    Measured: 24 hours

  13. Duration of urinary catheter

    in hours

    Measured: 24 hours

  14. Level of sensory block after procedure

    Measured by cold and pin prick sensation

    Measured: 24 hours

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 May 2018
  2. Study start1 May 2018
  3. Primary completion30 Oct 2018
  4. Study completion31 Dec 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Investigator
Enrolment
62 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03520205
Sponsor's protocol ID
IndonesiaUAnes021
Status last verified
Oct 2019
First submitted
15 Apr 2018
Last updated
22 Oct 2019
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Mathuram Thiyagarajan U, Bagul A, Nicholson ML. Pain management in laparoscopic donor nephrectomy: a review. Pain Res Treat. 2012;2012:201852. doi: 10.1155/2012/201852. Epub 2012 Oct 23.

    PubMed 23150820
  • SarinKapoor H, Kaur R, Kaur H. Anaesthesia for renal transplant surgery. Acta Anaesthesiol Scand. 2007 Nov;51(10):1354-67. doi: 10.1111/j.1399-6576.2007.01447.x.

    PubMed 17944639
  • Minnee RC, Idu MM. Laparoscopic donor nephrectomy. Neth J Med. 2010 May;68(5):199-206.

    PubMed 20508268
  • Buunen M, Gholghesaei M, Veldkamp R, Meijer DW, Bonjer HJ, Bouvy ND. Stress response to laparoscopic surgery: a review. Surg Endosc. 2004 Jul;18(7):1022-8. doi: 10.1007/s00464-003-9169-7. Epub 2004 May 12.

    PubMed 15136930
  • Desborough JP. The stress response to trauma and surgery. Br J Anaesth. 2000 Jul;85(1):109-17. doi: 10.1093/bja/85.1.109. No abstract available.

    PubMed 10927999
  • Das W, Bhattacharya S, Ghosh S, Saha S, Mallik S, Pal S. Comparison between general anesthesia and spinal anesthesia in attenuation of stress response in laparoscopic cholecystectomy: A randomized prospective trial. Saudi J Anaesth. 2015 Apr-Jun;9(2):184-8. doi: 10.4103/1658-354X.152881.

    PubMed 25829908
  • Gulyam Kuruba SM, Mukhtar K, Singh SK. A randomised controlled trial of ultrasound-guided transversus abdominis plane block for renal transplantation. Anaesthesia. 2014 Nov;69(11):1222-6. doi: 10.1111/anae.12704. Epub 2014 Jun 28.

    PubMed 24974901
  • Ueshima H, Otake H, Lin JA. Ultrasound-Guided Quadratus Lumborum Block: An Updated Review of Anatomy and Techniques. Biomed Res Int. 2017;2017:2752876. doi: 10.1155/2017/2752876. Epub 2017 Jan 3.

    PubMed 28154824
  • Skrekas G, Papalois VE, Mitsis M, Hakim NS. Laparoscopic live donor nephrectomy: a step forward in kidney transplantation? JSLS. 2003 Jul-Sep;7(3):197-206.

    PubMed 14558706
  • Oyen O, Scholz T, Hartmann A, Pfeffer P. Minimally invasive kidney transplantation: the first experience. Transplant Proc. 2006 Nov;38(9):2798-802. doi: 10.1016/j.transproceed.2006.08.102.

    PubMed 17112833
  • Jianda X, Yuxing Q, Yi G, Hong Z, Libo P, Jianning Z. Impact of Preemptive Analgesia on inflammatory responses and Rehabilitation after Primary Total Knee Arthroplasty: A Controlled Clinical Study. Sci Rep. 2016 Aug 31;6:30354. doi: 10.1038/srep30354.

    PubMed 27578313
  • Southworth SR, Woodward EJ, Peng A, Rock AD. An integrated safety analysis of intravenous ibuprofen (Caldolor((R))) in adults. J Pain Res. 2015 Oct 23;8:753-65. doi: 10.2147/JPR.S93547. eCollection 2015.

    PubMed 26604816
  • Spiro MD, Eilers H. Intraoperative care of the transplant patient. Anesthesiol Clin. 2013 Dec;31(4):705-21. doi: 10.1016/j.anclin.2013.09.005. Epub 2013 Nov 6.

    PubMed 24287348
  • Bhosale G, Shah V. Combined spinal-epidural anesthesia for renal transplantation. Transplant Proc. 2008 May;40(4):1122-4. doi: 10.1016/j.transproceed.2008.03.027.

    PubMed 18555130
  • Aditianingsih D, Pryambodho, Anasy N, Tantri AR, Mochtar CA. A randomized controlled trial on analgesic effect of repeated Quadratus Lumborum block versus continuous epidural analgesia following laparoscopic nephrectomy. BMC Anesthesiol. 2019 Dec 5;19(1):221. doi: 10.1186/s12871-019-0891-7.

    PubMed 31805855

Questions about this trial

What is this clinical trial studying?

A study testing Quadratus Lumborum Block and Continuous Epidural in people with Renal Transplant Donor of Left Kidney, run by Universitas Indonesia at 1 site in Indonesia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 22 Oct 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Indonesia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from Baseline Interleukin-6 at 24 hours after abdominal insufflation (time frame: Before procedure, at the end of surgery, and 24 hours after abdominal insufflation). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03520205, which also lists 15 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Oct 2019.

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