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Comparison of ESP and QL Blocks for Postoperative Pain in Pediatric Appendectomy (ESP-QLB)

NCT ID: NCT07301528

Last Updated: 2025-12-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

42 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-01

Study Completion Date

2026-05-15

Brief Summary

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This prospective randomized controlled clinical trial aims to compare the analgesic effectiveness of the Erector Spinae Plane (ESP) block and the Quadratus Lumborum (QL) block in pediatric patients undergoing appendectomy. Both regional anesthesia techniques have been shown to reduce opioid requirements and improve postoperative recovery in children; however, there is limited evidence directly comparing their efficacy. In this study, eligible participants will be randomly assigned to receive either an ESP or a QL block in addition to standard general anesthesia before surgical incision. Postoperative outcomes will include pain scores, total opioid consumption, time to first analgesic requirement, mobilization time, parental satisfaction, length of hospital stay, and block-related complications. The findings are expected to guide clinicians in selecting the most effective regional anesthesia technique for postoperative pain control in pediatric appendectomy.

Detailed Description

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Appendectomy is one of the most common emergency surgical procedures in children, and effective postoperative analgesia plays a key role in patient comfort, early mobilization, and reduced opioid exposure. Regional anesthesia techniques have gained increasing importance in pediatric anesthesia due to their opioid-sparing effect and favorable safety profile. Among these techniques, the Erector Spinae Plane (ESP) block and the Quadratus Lumborum (QL) block have shown promising results; however, there is a lack of high-quality randomized controlled trials directly comparing their clinical efficacy in pediatric appendectomy.

This study will prospectively enroll pediatric patients between 6 and 14 years of age who are scheduled to undergo appendectomy. After obtaining informed parental consent, participants will be randomly allocated to either the ESP block group or the QL block group. All blocks will be performed under ultrasound guidance using 0.25% bupivacaine at a dose of 0.5 mL/kg following the induction of general anesthesia. Standardized postoperative analgesia protocols will be applied to all participants.

Pain scores will be measured at predefined time points using a validated pediatric pain scale. Secondary outcomes will include total opioid consumption during the first 24 hours, the time to first rescue analgesic requirement, mobilization time, length of hospital stay, parental satisfaction scores, and any block-related complications. Patient data will be collected by trained investigators who will be blinded to group allocation.

The goal of this trial is to determine whether ESP or QL block provides superior postoperative pain control and recovery in pediatric appendectomy. The results may contribute to evidence-based recommendations for regional anesthesia selection in pediatric surgical practice.

Conditions

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Quadratus Lumborum Nerve Block Erector Spinae Block

Keywords

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Erector Spinae Plane Block Quadratus Lumborum Block Regional Anesthesia Pediatric Appendectomy Postoperative Pain Ultrasound-Guided Nerve Blocks Analgesic Requirement

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomly assigned in a 1:1 ratio to one of two parallel intervention arms: ultrasound-guided Erector Spinae Plane block or ultrasound-guided Quadratus Lumborum block, both performed under general anesthesia before surgical incision.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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QLB Block

Ultrasound-guided transmuscular QL block using 0.25% bupivacaine (0.5 mL/kg) before surgical incision.

Group Type EXPERIMENTAL

Quadratus Lumborum Block (QLB)

Intervention Type DRUG

Ultrasound-guided transmuscular QL block performed under general anesthesia using 0.25% bupivacaine (0.5 mL/kg) before surgical incision.

ESP Block

Ultrasound-guided ESP block at the L1 level using 0.25% bupivacaine (0.5 mL/kg) before surgical incision.

Group Type ACTIVE_COMPARATOR

Erector Spinae Plane Block

Intervention Type DRUG

Ultrasound-guided ESP block at the L1 level under general anesthesia using 0.25% bupivacaine (0.5 mL/kg) before surgical incision.

Interventions

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Quadratus Lumborum Block (QLB)

Ultrasound-guided transmuscular QL block performed under general anesthesia using 0.25% bupivacaine (0.5 mL/kg) before surgical incision.

Intervention Type DRUG

Erector Spinae Plane Block

Ultrasound-guided ESP block at the L1 level under general anesthesia using 0.25% bupivacaine (0.5 mL/kg) before surgical incision.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patients aged 3-12 years
* Diagnosis of acute appendicitis requiring appendectomy
* ASA physical status I-II
* Planned general anesthesia with intraoperative regional block (ESP or QL block)
* Written informed consent obtained from parents or legal guardians

Exclusion Criteria

* Refusal of regional block by family or anesthesia team
* Coagulopathy or anticoagulant medication use
* Local infection at the block injection site
* Known allergy or contraindication to local anesthetics
* Neurological or neuromuscular disorders
* Cognitive impairment preventing postoperative pain assessment
* Conversion to open surgery
* Intraoperative complications requiring deviation from study protocol
Minimum Eligible Age

3 Years

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Zeycan Kahya

OTHER

Sponsor Role lead

Responsible Party

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Zeycan Kahya

Medicine of Doctor

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Kutahya City Hospital

Kütahya, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

Central Contacts

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Zeycan Kahya, MD

Role: CONTACT

Phone: +90-545-270-8577

Email: [email protected]

Facility Contacts

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Zeycan Kahya, MD

Role: primary

Other Identifiers

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KSBU-ESPQL-2026

Identifier Type: -

Identifier Source: org_study_id