No quadriceps muscle weakness following anterior quadratus lumborum block compared with placebo: a randomized, non-inferiority, blinded, volunteer trial
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No quadriceps muscle weakness following anterior quadratus lumborum block compared with placebo : a randomized, non-inferiority, blinded, volunteer trial. / Tanggaard, Katrine; Nielsen, Martin Vedel; Holm, Ulrik Heiner Ullerup; Hoffmann, Balthazar Malmkjær; Bernhoff, Charlotte; Andersen, Christian H. S.; Thomassen, Sophia S.; Hansen, Christian; Dam, Mette; Poulsen, Troels Dirch; Holm, Pætur Mikal; Børglum, Jens.
In: Regional Anesthesia and Pain Medicine, 16.05.2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - No quadriceps muscle weakness following anterior quadratus lumborum block compared with placebo
T2 - a randomized, non-inferiority, blinded, volunteer trial
AU - Tanggaard, Katrine
AU - Nielsen, Martin Vedel
AU - Holm, Ulrik Heiner Ullerup
AU - Hoffmann, Balthazar Malmkjær
AU - Bernhoff, Charlotte
AU - Andersen, Christian H. S.
AU - Thomassen, Sophia S.
AU - Hansen, Christian
AU - Dam, Mette
AU - Poulsen, Troels Dirch
AU - Holm, Pætur Mikal
AU - Børglum, Jens
N1 - © American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2024/5/16
Y1 - 2024/5/16
N2 - BACKGROUND AND AIMS: Anterior quadratus lumborum block is a truncal block, applied in close proximity to the lumbar plexus, potentially causing lower limb weakness. This trial aimed to evaluate whether a unilateral anterior quadratus lumborum block caused quadriceps muscle weakness compared with placebo.METHODS: In this randomized, non-inferiority, triple-blind trial, 20 healthy volunteers received an active unilateral anterior quadratus lumborum block with 30 mL ropivacaine 0.75% and a placebo block on the contralateral side. Primary outcome was change in maximal quadriceps muscle strength from baseline to 60 min postblock compared with placebo. Secondary outcomes were change in single-leg 6 m timed hop test, change in Timed-Up and Go test, change in mean arterial pressure from baseline to 30 min postblock and dermatomal affection.RESULTS: There was no statistically significant difference in changes in maximal quadriceps muscle strength between active and placebo block; 15.88 N (95% CI -12.19 to +43.94), pnon-inf=0.003, indicating non-inferiority. Timed-Up and Go test was performed significantly faster 60 min postblock; -0.23 s (95% CI -0.38 to -0.08, p=0.005). Mean change in mean arterial pressure from baseline to 30 min postblock was 4.25 mm Hg (95% CI 0.24 to 8.26, p=0.04). Dermatome testing revealed an affection primarily of the lower abdomen (Th10-L1) with the active block.CONCLUSION: In this randomized controlled trial including healthy volunteers a unilateral anterior quadratus lumborum block does not cause statistical or clinical significant motor block of the quadriceps muscle compared with placebo. When administered correctly, the block can be used for procedures where early postoperative mobilization is essential.TRIAL REGISTRATION NUMBER: NCT05023343.
AB - BACKGROUND AND AIMS: Anterior quadratus lumborum block is a truncal block, applied in close proximity to the lumbar plexus, potentially causing lower limb weakness. This trial aimed to evaluate whether a unilateral anterior quadratus lumborum block caused quadriceps muscle weakness compared with placebo.METHODS: In this randomized, non-inferiority, triple-blind trial, 20 healthy volunteers received an active unilateral anterior quadratus lumborum block with 30 mL ropivacaine 0.75% and a placebo block on the contralateral side. Primary outcome was change in maximal quadriceps muscle strength from baseline to 60 min postblock compared with placebo. Secondary outcomes were change in single-leg 6 m timed hop test, change in Timed-Up and Go test, change in mean arterial pressure from baseline to 30 min postblock and dermatomal affection.RESULTS: There was no statistically significant difference in changes in maximal quadriceps muscle strength between active and placebo block; 15.88 N (95% CI -12.19 to +43.94), pnon-inf=0.003, indicating non-inferiority. Timed-Up and Go test was performed significantly faster 60 min postblock; -0.23 s (95% CI -0.38 to -0.08, p=0.005). Mean change in mean arterial pressure from baseline to 30 min postblock was 4.25 mm Hg (95% CI 0.24 to 8.26, p=0.04). Dermatome testing revealed an affection primarily of the lower abdomen (Th10-L1) with the active block.CONCLUSION: In this randomized controlled trial including healthy volunteers a unilateral anterior quadratus lumborum block does not cause statistical or clinical significant motor block of the quadriceps muscle compared with placebo. When administered correctly, the block can be used for procedures where early postoperative mobilization is essential.TRIAL REGISTRATION NUMBER: NCT05023343.
U2 - 10.1136/rapm-2024-105313
DO - 10.1136/rapm-2024-105313
M3 - Journal article
C2 - 38754991
JO - Regional Anesthesia and Pain Medicine
JF - Regional Anesthesia and Pain Medicine
SN - 1098-7339
ER -
ID: 392877123