Comparison of the Effects of Quadratus Lumborum Block and Retrolaminar Block on Postoperative Pain in Lumbar Disc Herniation Surgery

Kocaeli University

Status: Active, not recruiting

Conditions: Postoperative Pain; Lumbar Disc Herniation

Treatments: Procedure: Retrolaminar Block; Procedure: Quadratus Lumborum Block

Study type: Interventional

Funder types: Other

Identifiers

NCT07166250

KANDEMIR-QLB-O

Details and patient eligibility

About

This study aims to compare the analgesic efficacy of quadratus lumborum block (QLB) and retrolaminar block (RLB) in patients undergoing lumbar disc herniation surgery. Both regional anesthesia techniques are increasingly used for postoperative pain management, but there is limited evidence directly comparing their effectiveness. The primary outcome is the postoperative pain score, while secondary outcomes include opioid consumption and patient satisfaction.

Full description

Effective postoperative pain management is essential in patients undergoing lumbar disc herniation surgery. Regional anesthesia techniques, such as quadratus lumborum block (QLB) and retrolaminar block (RLB), have been increasingly used as alternatives or adjuncts to systemic analgesics. QLB provides analgesia by targeting the thoracolumbar fascia and spreading to the paravertebral space, whereas RLB is considered a simpler and potentially safer approach with similar analgesic potential.

This randomized controlled clinical trial is designed to compare the efficacy and safety of QLB and RLB for postoperative pain control. Adult patients scheduled for elective lumbar disc herniation surgery under general anesthesia will be randomized into two groups. One group will receive ultrasound-guided QLB, and the other group will receive ultrasound-guided RLB before surgical incision.

The primary outcome is postoperative pain intensity measured using a numerical rating scale (NRS) at multiple time intervals within the first 24 hours after surgery. Secondary outcomes include total opioid consumption, time to first analgesic request, incidence of block-related complications, and overall patient satisfaction. The results of this study are expected to provide evidence for the optimal regional technique for postoperative analgesia in lumbar spine surgery.

Enrollment: 84 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Patients aged 18-65 years American Society of Anesthesiologists (ASA) physical status I-II-III Scheduled for elective lumbar disc herniation surgery under general anesthesia Willing to participate and provide written informed consent Patients scheduled for elective lumbar disc herniation surgery

Exclusion criteria

Patients requiring emergency surgery ASA physical status classification IV-V Known coagulopathy Ongoing anticoagulant therapy History of allergy to local anesthetics Localized infection at the block injection site Presence of spinal, paraspinal, or regional deformities at the block area Inability to understand or use the verbal pain rating scale Chronic use of analgesic medications

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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84 participants in 2 patient groups

Quadratus Lumborum Block

Experimental group

Description:

Patients randomized to this group will receive an ultrasound-guided quadratus lumborum block (QLB) with local anesthetic injection before surgical incision for postoperative pain management.

Treatment:

Procedure: Quadratus Lumborum Block

Retrolaminar Block

Experimental group

Description:

Patients randomized to this group will receive an ultrasound-guided retrolaminar block (RLB) with local anesthetic injection before surgical incision for postoperative pain management.

Treatment:

Procedure: Retrolaminar Block