No quadriceps muscle weakness following anterior quadratus lumborum block compared with placebo: a randomized, non-inferiority, blinded, volunteer trial (2024)

Tanggaard, K., Nielsen, M. V., Holm, U. H. U., Hoffmann, B. M., Bernhoff, C., Andersen, C. H. S., Thomassen, S. S., Hansen, C., Dam, M., Poulsen, T. D., Holm, P. M., & Børglum, J. (2024). No quadriceps muscle weakness following anterior quadratus lumborum block compared with placebo: a randomized, non-inferiority, blinded, volunteer trial. Regional Anesthesia and Pain Medicine. Advance online publication. https://doi.org/10.1136/rapm-2024-105313

Tanggaard, Katrine ; Nielsen, Martin Vedel ; Holm, Ulrik Heiner Ullerup et al. / No quadriceps muscle weakness following anterior quadratus lumborum block compared with placebo : a randomized, non-inferiority, blinded, volunteer trial. In: Regional Anesthesia and Pain Medicine. 2024.

@article{956f7ec5cf1a4f4ba4bc9e1831818d0f,

title = "No quadriceps muscle weakness following anterior quadratus lumborum block compared with placebo: a randomized, non-inferiority, blinded, volunteer trial",

abstract = "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.",

keywords = "anesthesia, local, nerve block, ultrasonography",

author = "Katrine Tanggaard and Nielsen, {Martin Vedel} and Holm, {Ulrik Heiner Ullerup} and Hoffmann, {Balthazar Malmkj{\ae}r} and Charlotte Bernhoff and Andersen, {Christian H.S.} and Thomassen, {Sophia S.} and Christian Hansen and Mette Dam and Poulsen, {Troels Dirch} and Holm, {P{\ae}tur Mikal} and Jens B{\o}rglum",

note = "Publisher Copyright: {\textcopyright} 2024 American Society of Regional Anesthesia & Pain Medicine. Published by BMJ.",

year = "2024",

month = may,

day = "16",

doi = "10.1136/rapm-2024-105313",

language = "English",

journal = "Regional Anesthesia and Pain Medicine",

issn = "1098-7339",

publisher = "Lippincott Williams & Wilkins",

}

Tanggaard, K, Nielsen, MV, Holm, UHU, Hoffmann, BM, Bernhoff, C, Andersen, CHS, Thomassen, SS, Hansen, C, Dam, M, Poulsen, TD, Holm, PM & Børglum, J 2024, 'No quadriceps muscle weakness following anterior quadratus lumborum block compared with placebo: a randomized, non-inferiority, blinded, volunteer trial', Regional Anesthesia and Pain Medicine. https://doi.org/10.1136/rapm-2024-105313

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 et al.
In: Regional Anesthesia and Pain Medicine, 16.05.2024.

Research output: Contribution to journal › Journal article › Research › peer-review

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 - Publisher Copyright:© 2024 American Society of Regional Anesthesia & Pain Medicine. 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.

KW - anesthesia, local

KW - nerve block

KW - ultrasonography

UR - http://www.scopus.com/inward/record.url?scp=85193906163&partnerID=8YFLogxK

U2 - 10.1136/rapm-2024-105313

DO - 10.1136/rapm-2024-105313

M3 - Journal article

C2 - 38754991

AN - SCOPUS:85193906163

SN - 1098-7339

JO - Regional Anesthesia and Pain Medicine

JF - Regional Anesthesia and Pain Medicine

ER -

Tanggaard K, Nielsen MV, Holm UHU, Hoffmann BM, Bernhoff C, Andersen CHS et al. No quadriceps muscle weakness following anterior quadratus lumborum block compared with placebo: a randomized, non-inferiority, blinded, volunteer trial. Regional Anesthesia and Pain Medicine. 2024 May 16. Epub 2024 May 16. doi: 10.1136/rapm-2024-105313