Comparison of the Intraoperative and Postoperative Effects of Ultrasound-guided Erector Spina Plane Block and Posterior Quadratus Lumborum Block in Patients Undergoing Lumbar Stabilization Surgery

NCT ID: NCT05845788

Last Updated: 2023-11-02

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 62 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2023-04-15
• Study Completion Date: 2023-08-02

Brief Summary

The investigators aimed to compare the effects of ultrasound guided erector spina plan block and posterior quadratus lumborum block on intraoperative and postoperative opioid consumption in patients who will undergo short segment lumbar stabilization surgery.

Detailed Description

All participants will be monitored with ECG, SpO2, non-invasive blood pressure. In induction, 1mg/kg 2% lidocaine, 2-3mg/kg propofol, 1mcg/kg fentanyl, 2mg midazolam, 0.6 mg/kg rocuronium will be used. Anesthesia depth will be monitored with BIS (bispectral index), and anesthesia will be maintained with 50% oxygen-air mixture and sevoflurane. After patient intubation, invasive artery cannulation will be performed on the non-dominant hand, and the patients will be placed in a prone position. 20 cc bupivacaine of 0.25% will be administered to both regions bilaterally, by following the rules of asepsis, with a 10 cm pajunk needle accompanied by USG, the needle site will be confirmed with 3 mm saline.

BIS will be kept in the range of 40-50 throughout the case, and invasive arterial monitoring will be performed. 1 g paracetamol, 1 mg/kg tramadol and 4 mg ondansetron will be administered to the patients 30 minutes before the end of the surgery.

After appropriate extubation and wakefulness, patients will be transferred to the postoperative anesthesia care unit (PACU), where they will be followed for 24 hours.

An intravenous (IV) patient-controlled analgesia device (PCA) containing 100ml of tramadol at a concentration of 4mg/cc will be inserted. No infusion will be given, and the bolus dose will be set to 20mg, with a lock time of 20 minutes. In the postoperative period, 50 mg of dexketoprofen will be administered every 8 hours.

VAS values, vital signs, and possible opioid side effects of the patients at 0, 1, 2, 6, 12 and 24 hours will be recorded. After completing 24 hours, the patient will be separated from the IV PCA device and transferred to the service.

Conditions

Postprocedural Analgesia; Opioid Consumption; Erector Spina Plan Block; Quadratus Lumborum Block

Study Design

• Observational Model Type: CASE_ONLY
• Study Time Perspective: PROSPECTIVE

Study Groups

Erector Spina Plan Block Group (Group E)

Patients who underwent erector spina plane block before initiation of surgery after induction of anesthesia

Peripheral nerve block

Intervention Type: PROCEDURE

Ultrasound guided peripheral nerve block

Posterior Quadratus Lumborum Block Group ( Group Q)

Patients who underwent posterior quadratus lumborum block block before initiation of surgery after induction of anesthesia

Peripheral nerve block

Intervention Type: PROCEDURE

Ultrasound guided peripheral nerve block

Interventions

Peripheral nerve block

Ultrasound guided peripheral nerve block

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Patients who will undergo lumbar stabilization operation
• Between the ages of 18-65
• Both genders
• ASA I-III risk group

Exclusion Criteria

• Patients who did not accept the study
• Patients younger than 18 years old
• Patients older than 65 years
• Patients with an ASA score greater than III
• Patients with an active infection in the area to be blocked
• Patients with a long bleeding time
• Those who are pregnant
• Patients with kidney failure
• Patients with liver failure
• Patients with BMI<18 and BMI>30
• Those who are allergic to local anesthetics
• Patients who have had previous lumbar surgery
• Uncooperative or mentally retarded patients

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Ankara City Hospital Bilkent

OTHER

Sponsor Role: lead

Responsible Party

Nihal Gökbulut Özaslan

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Ankara City Hospital, Bilkent

Ankara, Cankaya, Turkey (Türkiye)

Countries

Turkey (Türkiye)

References

Qiu Y, Zhang TJ, Hua Z. Erector Spinae Plane Block for Lumbar Spinal Surgery: A Systematic Review. J Pain Res. 2020 Jul 1;13:1611-1619. doi: 10.2147/JPR.S256205. eCollection 2020.

Reference Type: BACKGROUND

PMID: 32669870 (View on PubMed)

Dhanjal ST, Tonder S. Quadratus Lumborum Block. 2023 Aug 14. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK537212/

Reference Type: BACKGROUND

PMID: 30725897 (View on PubMed)

Elsharkawy H, El-Boghdadly K, Barrington M. Quadratus Lumborum Block: Anatomical Concepts, Mechanisms, and Techniques. Anesthesiology. 2019 Feb;130(2):322-335. doi: 10.1097/ALN.0000000000002524. No abstract available.

Reference Type: BACKGROUND

PMID: 30688787 (View on PubMed)

Kang R, Lee S, Kim GS, Jeong JS, Gwak MS, Kim JM, Choi GS, Cho YJ, Ko JS. Comparison of Analgesic Efficacy of Erector Spinae Plane Block and Posterior Quadratus Lumborum Block in Laparoscopic Liver Resection: A Randomized Controlled Trial. J Pain Res. 2021 Dec 11;14:3791-3800. doi: 10.2147/JPR.S343366. eCollection 2021.

Reference Type: BACKGROUND

PMID: 34924770 (View on PubMed)

Other Identifiers

E1-23-.3166

Identifier Type: -

Identifier Source: org_study_id