Analgesic Outcomes of Ultrasound-Guided QLB vs TAP Block in Midline Laparotomy

Sponsor
Sheikh Zayed Medical College
Study ID
NCT07796828
Status
Not Yet Recruiting

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Conditions

  • Abdominal Surgery
  • Midline Laparotomy
  • Postoperative Pain

Eligibility Criteria

Sex
ALL
Age
18 Years - 65 Years
Healthy Volunteers
Not accepted

Interventions

  • Ultrasound-Guided Lateral Quadratus Lumborum Block (QL1) — PROCEDURE
    After induction of general anesthesia and before surgical incision, under strict aseptic precautions, a low-frequency curvilinear ultrasound transducer is placed between the costal margin and iliac crest. An echogenic 22-gauge 80-100 mm block needle is advanced in-plane toward the anterolateral border of the quadratus lumborum muscle near the junction of the transversus abdominis aponeurosis and transversalis fascia. After hydrodissection and negative aspiration, 20 mL of 0.25% bupivacaine is injected on each side under continuous ultrasound visualization of local anesthetic spread. Total planned volume 40 mL (100 mg bupivacaine), not exceeding 2 mg/kg.
  • Ultrasound-Guided Transversus Abdominis Plane Block — PROCEDURE
    After induction of general anesthesia and before surgical incision, under strict aseptic precautions, a high-frequency linear ultrasound transducer is placed transversely on the anterolateral abdominal wall between the costal margin and iliac crest. The external oblique, internal oblique, and transversus abdominis muscles are identified. An echogenic 22-gauge block needle is advanced in-plane until the tip lies in the fascial plane between the internal oblique and transversus abdominis muscles. After hydrodissection and negative aspiration, 20 mL of 0.25% bupivacaine is injected on each side under continuous ultrasound visualization of local anesthetic spread. Total planned volume 40 mL (100 mg bupivacaine), not exceeding 2 mg/kg.
  • Bupivacaine 0.25% — DRUG
    Local anesthetic used for both QLB and TAP blocks: 20 mL of 0.25% bupivacaine per side (total 40 mL / 100 mg), dose adjusted not to exceed 2 mg/kg body weight.

Study Details

This randomized controlled trial compares the analgesic efficacy of ultrasound-guided bilateral lateral quadratus lumborum block (QLB, QL1) versus ultrasound-guided bilateral transversus abdominis plane (TAP) block in adults undergoing elective midline laparotomy under general anesthesia. The primary focus is postoperative pain intensity, time to first rescue analgesia, proportion requiring rescue analgesia, and total opioid consumption in the first 24 hours.

Key Dates

First listed
Sep 1, 2026
Start date
Sep 30, 2026
Status verified
Aug 2026
Primary completion
Mar 31, 2027
Completion
Mar 31, 2027

Study Design

Enrollment
100 participants (estimated)
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT

Arms

  • Experimental: Group A: Quadratus Lumborum Block (QLB)
    Participants receive bilateral ultrasound-guided lateral quadratus lumborum (QL1) block after induction of general anesthesia and before surgical incision. 20 mL of 0.25% bupivacaine is injected on each side (total 40 mL / 100 mg, dose not exceeding 2 mg/kg).
  • Active Comparator: Group B: Transversus Abdominis Plane Block (TAPB)
    Participants receive bilateral ultrasound-guided transversus abdominis plane block after induction of general anesthesia and before surgical incision. 20 mL of 0.25% bupivacaine is injected on each side (total 40 mL / 100 mg, dose not exceeding 2 mg/kg).

Primary Outcome Measure

Postoperative pain intensity at 12 hours [ Time Frame: 12 hours after completion of surgery ]

Central Contacts

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