Postoperative Pain
Conditions
Keywords
Quadro-Iliac Plane Block, Lumbar Instrumentation Surgery, Pain Management
Brief summary
Lumbar instrumentation surgery is associated with significant postoperative pain. This study evaluates the analgesic effectiveness of the ultrasound-guided Quadro-Iliac Plane Block in patients undergoing lumbar instrumentation surgery, aiming to assess the efficacy of this newly developed technique for postoperative pain management.
Detailed description
Lumbar instrumentation surgery is associated with significant postoperative pain, which may reduce patient comfort, delay early mobilization, and increase analgesic requirements. Effective postoperative pain management is essential for enhancing recovery and reducing postoperative morbidity. In this context, regional anesthesia techniques have become an important component of multimodal analgesia strategies. The Quadro-Iliac Plane Block is a newly described ultrasound-guided regional analgesia technique. This block aims to provide effective analgesia by targeting the relevant branches of the lumbar nerves supplying the surgical area. However, clinical evidence regarding its effectiveness in postoperative analgesia following lumbar instrumentation surgery remains limited. This study aims to evaluate the postoperative analgesic effectiveness of the ultrasound-guided Quadro-Iliac Plane Block in patients undergoing lumbar instrumentation surgery. The findings of this study are expected to contribute to the assessment of this newly developed technique as a safe and effective option for postoperative pain management in lumbar spine surgery.
Interventions
PROCEDUREQuadro-Iliac Plane Block
Ultrasound-guided regional anesthesia technique performed between the erector spinae muscle and the quadratus lumborum muscle at the iliac crest level.
Sponsors
Bursa City Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Classified as American Society of Anesthesiologists (ASA) physical status I-III * Scheduled for elective lumbar instrumentation surgery * Surgery performed under general anesthesia * Provision of written informed consent
Exclusion criteria
* Use of anticoagulant or antiplatelet medications * Presence of bleeding diathesis or coagulation disorders * Known allergy or hypersensitivity to local anesthetics or opioid medications * Infection at the planned block site * Alcohol or drug dependence * Cognitive impairment preventing reliable pain assessment using the NRS * Pregnancy or lactation * History of previous lumbar spine surgery * Diabetes mellitus * Renal or hepatic impairment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative 48-Hour PCA Opioid Consumption | Postoperative 0-8, 8-16, 16-24, 24-48 intervals | Total amount of opioid delivered by the patient-controlled analgesia (PCA) device during the first 48 hours after surgery, recorded in milligrams (mg). |
| QoR-15 Recovery Score | Postoperative 24th and 48th hours | The investigators will use the Turkish version of Quality of Recovery (QoR) / QoR-15 questionairre PART A How have you been feeling in the last 24 hours? (0 to 10, where: 0 = none of the time \[poor\] and 10 = all of the time \[excellent\]) Able to breathe easily Been able to enjoy food Feeling rested Have had a good sleep Able to look after personal toilet and hygiene unaided Able to communicate with Getting support from hospital doctors and nurses Able to return to work or usual home activities Feeling comfortable and in control Having a feeling of general well-being PART B Have you had any of the following in the last 24 hours? (10 to 0, where: 10 = none of the time \[excellent\] and 0 = all of the time \[poor\]) Moderate pain Severe pain Nausea or vomiting Feeling worried or anxious Feeling sad or depressed |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Dynamic and static NRS scores | 0, 2, 4, 8, 16, 24, and 48 hours postoperatively | Numeric Rating Scale (NRS) (0-10) pain scores at rest or movement at predefined postoperative hours |
| Total rescue analgesic dose | Postoperative 24th and 48th hours | Despite the use of patient-controlled analgesia (PCA), if the Numeric Rating Scale (NRS) score is ≥4 at any time point, 0.5 mg/kg intravenous meperidine will be administered as rescue analgesia. Total amount of meperidin during the first 24 and 48 hours after surgery, recorded in milligrams (mg). |
| Time of first request for rescue analgesia | Postoperative 48-Hours | Despite the use of patient-controlled analgesia (PCA), if the Numeric Rating Scale (NRS) score is ≥4 at any time point, 0.5 mg/kg intravenous meperidine will be administered as rescue analgesia. |
| Length of Hospital Stay | Patients will remain under observation for at least 2 weeks until their postoperative discharge. Follow-up will be completed upon discharge. The length of hospital stay will be recorded (day). | Length of hospital stay will be defined as the number of days from the end of surgery to hospital discharge. |
| Block and Opioid-Related Adverse Effects and Complications | Postoperative 48-Hours | Block- and opioid-related adverse effects and complications, including but not limited to local anesthetic toxicity, hematoma, infection, nerve injury, nausea, vomiting, pruritus, sedation, and respiratory depression, will be recorded |
Countries
Turkey (Türkiye)
Contacts
CONTACTMursel Ekinci, Assoc prof,MD
CONTACTMerih Yıldız Eglen, MD
Outcome results
None listed