Erector Spinae Plane Block vs Quadro-Iliac Plane Block After Lumbar Instrumentation Surgery

Bursa City Hospital

Status: Not yet enrolling

Conditions: Pain, Postoperative

Treatments: Procedure: Erector Spinae Plane Block; Procedure: Quadro-Iliac Plane Block

Study type: Interventional

Funder types: Other

Identifiers

NCT07354581

BursaCity Hos 2

Details and patient eligibility

About

Lumbar instrumentation surgery is associated with significant postoperative pain. This study compares the postoperative analgesic effectiveness of ultrasound-guided Erector Spinae Plane Block and Quadro-Iliac Plane Block in patients undergoing lumbar instrumentation surgery.

Full description

Lumbar instrumentation surgery is frequently associated with moderate to severe postoperative pain, which may negatively affect patient comfort, delay mobilization, and increase opioid consumption. Effective postoperative analgesia is therefore essential for improving recovery and reducing opioid-related adverse effects. Regional anesthesia techniques have become an important component of multimodal analgesia strategies in lumbar spine surgery.

The Erector Spinae Plane Block (ESPB) is a well-established ultrasound-guided regional anesthesia technique that has been shown to provide postoperative analgesia in various spinal procedures. The Quadro-Iliac Plane Block (QIPB) is a newly developed ultrasound-guided block targeting the fascial plane between the erector spinae muscle and the quadratus lumborum muscle at the level of the iliac crest, with the potential to provide effective analgesia for lumbar spine surgeries. However, comparative clinical data regarding the analgesic effectiveness of these two techniques in lumbar instrumentation surgery are limited.

This study is designed to compare the postoperative analgesic effectiveness of ultrasound-guided ESPB and QIPB in patients undergoing elective lumbar instrumentation surgery under general anesthesia. Both blocks will be performed using ultrasound guidance as part of a standardized multimodal analgesia protocol.

The findings of this study aim to clarify the relative effectiveness of ESPB and QIPB for postoperative pain control following lumbar instrumentation surgery and to contribute to evidence-based selection of regional analgesia techniques in lumbar spine procedures.

Enrollment: 80 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age between 18 and 65 years
• Classified as American Society of Anesthesiologists physical status I-III
• Scheduled for elective lumbar instrumentation surgery under general anesthesia
• Provision of written informed consent

Exclusion criteria

• Use of anticoagulant medications or presence of bleeding diathesis
• Known allergy or hypersensitivity to local anesthetics or opioid drugs
• Infection at the planned block site
• Alcohol or drug dependence
• Cognitive impairment preventing reliable pain assessment
• Pregnancy or lactation
• History of previous lumbar spine surgery
• Diabetes mellitus
• Renal or hepatic insufficiency

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

80 participants in 2 patient groups

Erector Spinae Plane Block (ESPB)

Active Comparator group

Description:

Participants in this arm will receive an ultrasound-guided Erector Spinae Plane Block at the end of surgery, before extubation, with the patient in the prone position under standard sterilization conditions. The block will be performed bilaterally as part of a standardized multimodal postoperative analgesia protocol following lumbar instrumentation surgery.

Treatment:

Procedure: Erector Spinae Plane Block

Quadro-Iliac Plane Block (QIPB)

Active Comparator group

Description:

Participants in this arm will receive an ultrasound-guided Quadro-Iliac Plane Block at the end of surgery, before extubation, with the patient in the prone position under standard sterilization conditions. The block will be performed bilaterally as part of a standardized multimodal postoperative analgesia protocol following lumbar instrumentation surgery.

Treatment:

Procedure: Quadro-Iliac Plane Block