Comparing Thoracolumbar Interfascial and Quadro Iliac Plane Blocks on Postoperative Opioid Use Following Lumbar Microsurgery

NCT06851533 | Recruiting

• 1 other identifier: Lumbar tlip vs quadroilaac
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

Lumbar microdiscectomy is a commonly used surgical procedure for treating herniated discs. Effective postoperative analgesia is crucial for early mobilization and functional recovery. Uncontrolled postoperative pain can delay recovery, increase the risk of opioid dependence, and lead to respiratory complications. Although opioid analgesics effectively reduce pain, they can cause side effects such as nausea, vomiting, respiratory depression, and dependency. Therefore, non-opioid analgesic methods are preferred for patient safety and comfort. Recently, regional anesthesia techniques such as the Thoracolumbar Interfascial Plane (TLIP) block and the Quadro Iliac Plane Block have been introduced for postoperative pain management in lumbar surgeries. However, there are not enough studies comparing the superiority of these two methods. Study Objective: The primary aim of this study is to evaluate the effects of ultrasound-guided TLIP and Quadro Iliac Plane Blocks on postoperative opioid consumption after lumbar microsurgery. The secondary aim is to compare opioid-related side effects (such as nausea, vomiting, respiratory depression, etc.) and postoperative NRS pain scores between the groups.

Conditions

Lumbar Microdiscectomy; Nerve Block

Keywords

Postoperative pain; Ultrasound-guided nerve block

Outcome Measures

Primary Outcomes (1)

• tramadol consumption

  Total tramadol consumption (mg) in the first 24 hours after surgery.

  first 24 hours after the operation

Secondary Outcomes (2)

• NRS (Numerical Rating Scale) pain scores

  first 24 hours after the operation

• opioid-related side effects (such as nausea, vomiting, respiratory depression)

  first 24 hours after the operation

Study Arms (3)

No Block (Control Group)

ACTIVE COMPARATOR

Patients receive standard perioperative analgesia without any additional regional block.

Procedure: Standard Analgesia (No Block)

TLIP Block

EXPERIMENTAL

Patients receive the Thoracolumbar Interfascial Plane (TLIP) block in addition to standard perioperative analgesia.

Procedure: Thoracolumbar Interfascial Plane (TLIP) Block

Quadro Iliac Plane Block

EXPERIMENTAL

Patients receive the Quadro Iliac Plane Block in addition to standard perioperative analgesia.

Procedure: Quadro Iliac Plane Block

Interventions

Standard Analgesia (No Block) PROCEDURE

Participants receive standard perioperative analgesia (including intravenous paracetamol/tramadol), but no additional regional block is applied.

No Block (Control Group)

Thoracolumbar Interfascial Plane (TLIP) Block PROCEDURE

In addition to standard perioperative analgesia, a TLIP block is performed under sterile conditions and ultrasound guidance, after the surgical procedure is completed but before the patient is awakened. A total of 20 mL of 0.25% bupivacaine is injected into the thoracolumbar fascial plane, and spread is confirmed via ultrasound.

TLIP Block

Quadro Iliac Plane Block PROCEDURE

In addition to standard perioperative analgesia, a Quadro Iliac Plane Block is performed under sterile conditions and ultrasound guidance, after the surgical procedure is completed but before the patient is awakened. A total of 20 mL of 0.25% bupivacaine is injected into the quadro iliac plane at the level of the iliac crest, and spread is confirmed via ultrasound.

Quadro Iliac Plane Block

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients aged 18 to 80 years
• American Society of Anesthesiologists (ASA) physical status I to III
• scheduled for lumbar microdiscectomy surgery

You may not qualify if:

• Known allergy to local anesthetics
• Any other significant drug allergies related to the study interventions
• Pregnancy
• Pre-existing psychiatric or neurological disorders
• Inability to provide informed consent

Sponsors & Collaborators

• Medipol University: lead

Study Sites (1)

Medipol University

Istanbul, Turkey (Türkiye)

RECRUITING

Related Publications (3)

• Canikli Adiguzel S, Akyurt D, Bahadir Altun H, Ultan Ozgen G, Akdeniz S, Bayraktar B, Tulgar S, Yigit Y. Posterior Quadratus Lumborum Block or Thoracolumbar Interfascial Plane Block and Postoperative Analgesia after Spinal Surgery: A Randomized Controlled Trial. J Clin Med. 2023 Nov 21;12(23):7217. doi: 10.3390/jcm12237217.

  PMID: 38068268 BACKGROUND

• Hu Z, Han J, Jiao B, Jiang J, Sun Y, Lv Z, Wang J, Tian X, Wang H. Efficacy of Thoracolumbar Interfascial Plane Block for Postoperative Analgesia in Lumbar Spine Surgery: A Meta-analysis of Randomized Clinical Trials. Pain Physician. 2021 Nov;24(7):E1085-E1097.

  PMID: 34704718 BACKGROUND

• Yildirim Uslu E. Effect of Quadratus Lumborum Block in Patients With Acute-Subacute Unilateral Lumbar Strain. Cureus. 2024 May 24;16(5):e61014. doi: 10.7759/cureus.61014. eCollection 2024 May.

  PMID: 38915966 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative

Interventions

Dental Occlusion

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Intervention Hierarchy (Ancestors)

Dentistry; Dental Physiological Phenomena; Digestive System and Oral Physiological Phenomena

Central Study Contacts

Burak Ömür

CONTACT

+905056215056; burakomur@outlook.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: February 24, 2025
• First Posted: February 28, 2025
• Study Start: March 10, 2025
• Primary Completion: March 10, 2026
• Study Completion: April 10, 2026
• Last Updated: December 8, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will share

Locations

TU (1)