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

NCT ID: NCT07166250

Last Updated: 2025-09-10

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 84 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-05-16
• Study Completion Date: 2026-05-15

Brief Summary

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.

Detailed 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.

Conditions

Lumbar Disc Herniation; Postoperative Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

Quadratus Lumborum Block

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.

Group Type: EXPERIMENTAL

Quadratus Lumborum Block

Intervention Type: PROCEDURE

Ultrasound-guided quadratus lumborum block performed preoperatively using local anesthetic injection at the thoracolumbar fascia for postoperative analgesia in lumbar disc herniation surgery.

Retrolaminar Block

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

Group Type: EXPERIMENTAL

Retrolaminar Block

Intervention Type: PROCEDURE

Ultrasound-guided retrolaminar block performed preoperatively using local anesthetic injection into the retrolaminar space for postoperative analgesia in lumbar disc herniation surgery

Interventions

Quadratus Lumborum Block

Ultrasound-guided quadratus lumborum block performed preoperatively using local anesthetic injection at the thoracolumbar fascia for postoperative analgesia in lumbar disc herniation surgery.

Intervention Type: PROCEDURE

Retrolaminar Block

Ultrasound-guided retrolaminar block performed preoperatively using local anesthetic injection into the retrolaminar space for postoperative analgesia in lumbar disc herniation surgery

Intervention Type: PROCEDURE

Eligibility Criteria

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

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

Sponsors

Kocaeli University

OTHER

Sponsor Role: lead

Responsible Party

Nermin Kandemir

research assistant

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

dilek icli, prof. dr.

Role: PRINCIPAL_INVESTIGATOR

Kocaeli University, Department of Anesthesiology and Reanimation

Locations

Kocaeli University Hospital

Kocaeli, , Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

KANDEMIR-QLB-O

Identifier Type: -

Identifier Source: org_study_id