Lumbar Disc Herniation, Postoperative Pain
Conditions
Keywords
Quadratus Lumborum Block, Retrolaminar Block, Spine Surgery Analgesia, Opioid Consumption
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 postoperative opioid consumption, while secondary outcomes include postoperative pain scores
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 total postoperative morphine consumption during the first 24 hours after surgery. Secondary outcomes include postoperative pain intensity measured using the Numerical Rating Scale (NRS) at multiple time points within the first 24 hours, the need for rescue analgesia, postoperative nausea and vomiting (PONV), and block-related complications.
Interventions
PROCEDUREQuadratus 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.
PROCEDURERetrolaminar Block
Ultrasound-guided retrolaminar block performed preoperatively using local anesthetic injection into the retrolaminar space for postoperative analgesia in lumbar disc herniation surgery
Sponsors
Kocaeli University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Intervention model description
Two-arm randomized controlled trial comparing quadratus lumborum block and retrolaminar block in patients undergoing lumbar disc herniation surgery.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total Postoperative Opioid Consumption | Within the first 24 hours after surgery | Total cumulative amount of intravenous morphine consumed (in milligrams) via patient-controlled analgesia (PCA) device. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pain intensity (Numerical Rating Scale, NRS 0-10) | Within the first 24 hours after surgery | Pain intensity will be assessed using the Numerical Rating Scale (NRS), where 0 = no pain and 10 = worst imaginable pain. |
| Need for rescue analgesia | Within the first 24 hours after surgery | Number of patients requiring additional rescue analgesic medication during the postoperative period. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORdilek icli, prof. dr.
Kocaeli University, Department of Anesthesiology and Reanimation
Outcome results
None listed