US-Guided Quadro-Iliac Plane Block for Postoperative Analgesia After Lumbar Instrumentation (QIPB)

Bursa City Hospital

Status: Not yet enrolling

Conditions: Postoperative Pain

Treatments: Procedure: Quadro-Iliac Plane Block

Study type: Interventional

Funder types: Other

Identifiers

NCT07370428

BursaCityHOS 1

Details and patient eligibility

About

Lumbar instrumentation surgery is associated with significant postoperative pain. This study evaluates the analgesic effectiveness of the ultrasound-guided Quadro-Iliac Plane Block in patients undergoing lumbar instrumentation surgery, aiming to assess the efficacy of this newly developed technique for postoperative pain management.

Full description

Lumbar instrumentation surgery is associated with significant postoperative pain, which may reduce patient comfort, delay early mobilization, and increase analgesic requirements. Effective postoperative pain management is essential for enhancing recovery and reducing postoperative morbidity. In this context, regional anesthesia techniques have become an important component of multimodal analgesia strategies.

The Quadro-Iliac Plane Block is a newly described ultrasound-guided regional analgesia technique. This block aims to provide effective analgesia by targeting the relevant branches of the lumbar nerves supplying the surgical area. However, clinical evidence regarding its effectiveness in postoperative analgesia following lumbar instrumentation surgery remains limited.

This study aims to evaluate the postoperative analgesic effectiveness of the ultrasound-guided Quadro-Iliac Plane Block in patients undergoing lumbar instrumentation surgery. The findings of this study are expected to contribute to the assessment of this newly developed technique as a safe and effective option for postoperative pain management in lumbar spine surgery.

Enrollment: 80 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Classified as American Society of Anesthesiologists (ASA) physical status I-III
• Scheduled for elective lumbar instrumentation surgery
• Surgery performed under general anesthesia
• Provision of written informed consent

Exclusion criteria

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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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80 participants in 2 patient groups

Group QIPB

Active Comparator group

Description:

Participants in this arm will receive an ultrasound-guided Quadro-Iliac Plane Block. The block will be performed at the end of surgery, before extubation, with the patient in the prone position under standard sterilization conditions. A convex ultrasound probe will be placed at the level where the quadratus lumborum muscle (QLM) attaches to the iliac crest to visualize the erector spinae muscle (ESM) and the underlying QLM. The block location will be confirmed by injecting 2 mL of isotonic solution at the QLM-iliac crest junction. Subsequently, 20 mL of 0.25% bupivacaine will be injected, and the spread of the local anesthetic between the ESM and QLM will be observed under ultrasound guidance. The block will be performed bilaterally with a total volume of 40 mL.

Treatment:

Procedure: Quadro-Iliac Plane Block

Group Control

No Intervention group