Acute Pain, Spinal Stenosis
Conditions
Brief summary
The investigators aim to compare the postoperative analgesic efficacy of the classical thoracolumbar interfascial plane block and the Quadro-iliac plane block for postoperative analgesia management after lumbar disc surgery.
Detailed description
Lumbar spinal stenosis can lead to variable signs and symptoms such as back pain, radiating pain to the lower extremities, and reduced walking capacity. Lumbar disc surgery itself causes significant pain due to extensive dissection and muscle retraction during the procedure. A multimodal analgesic approach is preferred for postoperative pain management after lumbar spine surgery. The addition of regional anesthesia techniques can reduce opioid-related side effects and is associated with earlier mobilization, shorter hospital stay, and improved patient satisfaction. For patients undergoing lumbar disc surgery, the classical thoracolumbar interfascial plane (TLIP) block and the Quadro-iliac plane block (QIPB) provide effective analgesia for postoperative pain control.
Interventions
OTHERClassical thoracolumbar interfascial plane block
Classical thoracolumbar interfascial plane block will be performed under ultrasound guidance before the induction of general anesthesia.
Quadro-iliac plane block will be performed under ultrasound guidance before the induction of general anesthesia.
Sponsors
Samsun University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged 18-70 years, * Classified as ASA physical status I-III, * Scheduled to undergo single-level lumbar spinal surgery under general anesthesia * Who agree to participate in the study by providing written informed consent
Exclusion criteria
* History of bleeding diathesis or current anticoagulant therapy * Known allergy or hypersensitivity to local anesthetics or opioid medications * Infection at the planned block injection site * Previous lumbar spine surgery * History of gabapentinoid or corticosteroid use within the last 3 weeks * Inability to use a patient-controlled analgesia (PCA) device * Suspected pregnancy, confirmed pregnancy, or breastfeeding * Refusal to undergo the procedure or to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Opioid consumption | 24 hours | In the postoperative period, patients will be given opioids according to their pain density with a patient-controlled device, and the daily Morphine consumption in Patient Controlled Analgesia device will be collected and compared between groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Perioperative pain intensity | 24 hours | Changes in the Numerical Rating Scale (NRS) will be recorded at rest and during movement. The participant's baseline NRS will be recorded, followed by measurements before and after neuraxial positioning and up to 24 hours post-surgery. The NRS is a unidimensional measure of pain intensity in adults. It is a segmented numerical version of the Visual Analog Scale (VAS) where the participant selects a whole number (0-10) that best represents the intensity of their pain. The 11-point numerical scale ranges from '0' representing one end of the pain spectrum (e.g. 'no pain') to '10' representing the other end (e.g. 'worst imaginable pain'). |
| Postoperative nausea and vomiting | 24 hours | Postoperative nausea and vomiting (PONV): During follow-up, patients who experience nausea or vomiting will be evaluated using a verbal descriptive PONV scale (0=None, 1=Mild nausea, 2=Moderate nausea, 3=Single episode of vomiting, 4=More than one episode of vomiting). |
| Quality of recovery 15 scale | 24 hours after surgery | Postoperative Quality of Recovery 15 in Turkish scale. The QoR-15 (Quality of Recovery-15) questionnaire is a simple and practical tool used to assess postoperative recovery. It consists of 15 items, each scored on a numeric scale from 0 to 10, resulting in a total score ranging from 0 to 150. Based on the total score, postoperative recovery is categorized as follows: 136-150: Excellent recovery 122-135: Good recovery 90-121: Moderate recovery 0-89: Poor recovery |
Countries
Turkey (Türkiye)
Contacts
CONTACTHALE KEFELİ ÇELİK
CONTACTBETÜL ÇİFTÇİ KURT
Outcome results
None listed