Lateral QL Block vs Intrathecal Morphine for Cesarean Section

Starting soon · Not applicable · Has a placebo group

Conditions studied: Anesthesia, Postoperative Pain, Regional Anesthesia

In brief

Effective postoperative analgesia after cesarean delivery is essential for maternal recovery, early mobilization, breastfeeding, and maternal-infant bonding. Although intrathecal morphine (ITM) is considered the gold standard for post-cesarean analgesia, its use is associated with opioid-related adverse effects. Ultrasound-guided lateral quadratus lumborum block (QLB-I) has emerged as a promising alternative. This randomized, double-blind, non-inferiority trial aims to compare the postoperative analgesic efficacy of lateral QLB-I with ITM. Secondary outcomes include postoperative opioid consumption, pain scores, opioid-related adverse effects, quality of recovery (ObsQoR-11T), and maternal satisfaction.

Key facts

Study ID

NCT07712783

Run by

Ondokuz Mayıs University

People needed

56

Starts

2026-07-15

Expected to finish

2026-12-01

Last updated by the study team

2026-07-17

Who can join

Age: 18 and older, up to 45. Sex: female. Healthy volunteers: not accepted.

You may qualify if…

• Women aged between 18 and 45 years.
• Singleton term pregnancy (≥37 weeks of gestation).
• American Society of Anesthesiologists (ASA) physical status II.
• Scheduled to undergo elective cesarean delivery via a Pfannenstiel incision.
• Planned to receive spinal anesthesia for cesarean delivery.
• Provision of written informed consent following a comprehensive explanation of the study.
• Sufficient cognitive capacity to understand and complete the study assessment instruments, including the Numeric Rating Scale (NRS) and the ObsQoR-11T.

You may not qualify if…

• Known allergy or hypersensitivity to any of the study medications, including morphine, bupivacaine, or fentanyl.
• Coagulopathy (international normalized ratio [INR] >1.5 or platelet count <100,000/mm³).
• Current treatment with anticoagulant or antiplatelet agents (e.g., heparin, low-molecular-weight heparin, or aspirin >100 mg/day).
• Infection, hematoma, or skin lesion at the planned block insertion site.
• Diagnosis of preeclampsia, eclampsia, or HELLP syndrome.
• Placenta previa, placenta accreta spectrum, or placental abruption.
• Gestational diabetes mellitus or chronic hypertension.
• Emergency cesarean delivery indicated because of fetal distress.
• Conversion to general anesthesia during cesarean delivery.
• History of chronic pain syndrome (e.g., fibromyalgia, lumbar disc herniation, or neuropathic pain).
• Regular use of opioids or psychotropic medications within the preceding 3 months.
• Diagnosis of epilepsy, severe anxiety disorder, or major depressive disorder.
• Obesity (body mass index >35 kg/m²).
• Severe systemic disease, including New York Heart Association (NYHA) class III or IV heart failure, hepatic or renal failure, advanced respiratory disease, or obstructive sleep apnea.
• Advanced pulmonary disease requiring continuous positive airway pressure (CPAP) therapy.
• Inadequate spinal anesthesia or the requirement for supplemental intraoperative analgesia.
• Surgical duration exceeding 120 minutes.
• Excessive intraoperative blood loss (≥1,000 mL) or the need for blood transfusion.

Where it is running

• Ondokuz Mayis University — Samsun, Turkey (Türkiye)

Full record on ClinicalTrials.gov

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