Erector Spınae Plane Block and Transmuscular Quadratus Lumborum Block In Kıdney Transplantatıon

NCT07059455 | Completed DMC

• 1 other identifier: 2015/514/154/11
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Perioperative anesthesia and pain management are among the difficult situations for anesthesiologists to manage in kidney transplant patients. These patients are often complicated by comorbidities related to chronic kidney disease. The main issues in postoperative pain management for kidney transplant patients include dose adjustment, prevention of further renal damage, and maintenance of graft perfusion. Pain management in patients with end-stage renal disease may be inadequate due to limited options of systemic analgesics. In addition, regional analgesia techniques can be considered to avoid the adverse effects of anesthetics and systemic analgesics (1). Erector spinae plane block (ESPB) is a regional fascial plane block method developed in recent years. In this method, analgesia is provided by injecting local anesthetic between the transverse process and the erector spinae muscles and anesthetizing the dorsal and ventral branches of the regional spinal nerves. It has a wide range of applications including thoracic, lumbar, and thoracic and abdominal surgeries (2,3). Transmuscular quadratus lumborum block (TMQLB) is a nerve block technique in which local anesthetic is applied to the fascial plane between the psoas major (PM) and quadratus lumborum (QL) muscles. Anatomical evidence has shown that local anesthetic can spread through the thoracolumbar fascia into the thoracic paravertebral space, thus infiltrating the thoracic spinal nerves and sympathetic trunk, providing both somatic and visceral analgesia for abdominal surgery (4). This study aims to evaluate the analgesic efficacy of ESPB and TMQLB in terms of pain management after kidney transplantation. The primary aim of the study was to evaluate pain scores and analgesic consumption between groups in the 24-hour postoperative period. The secondary aim was to evaluate the time to first analgesic requirement after block, the number of patients requiring analgesics, and the levels of nausea and vomiting.

Conditions

Kidney Transplant

Keywords

erectör spiane block; Quadratus lumborum block

Outcome Measures

Primary Outcomes (1)

• evaluate pain scores and analgesic consumption between groups

  Patients' pain levels will be measured at 0, 1, 2, 6, 12, and 24 hours using a 10-point VAS. No pain will be assessed as 0 points, and severe pain will be assessed as 10 points.

  postoperative 24 hours

Study Arms (2)

erectör spinae plane block

ACTIVE COMPARATOR

Erector spinae plane block (ESPB) is a regional fascial plane block method developed in recent years. In this method, analgesia is provided by injecting local anesthetic between the transverse process and the erector spinae muscles and anesthetizing the dorsal and ventral branches of the regional spinal nerves. It has a wide range of use in thoracic, lumbar, and thoracic and abdominal surgeries

Other: Erector Spinae (ESP) Block with Bupivacaine (Marcaine®)

Transmuskuler quadratus lumborum block

ACTIVE COMPARATOR

Transmuscular quadratus lumborum block (TMQLB) is a nerve block technique in which local anesthetic is applied to the fascial plane between the psoas major (PM) and quadratus lumborum (QL) muscles. Anatomical evidence has shown that local anesthetic can spread through the thoracolumbar fascia into the thoracic paravertebral space, thus infiltrating the thoracic spinal nerves and sympathetic trunk, providing both somatic and visceral analgesia for abdominal surgery

Other: Quadratus Lumborum (QL) Block

Interventions

Erector Spinae (ESP) Block with Bupivacaine (Marcaine®) OTHER

Under general anesthesia, patients in the ESP group will be positioned in the left or right lateral decubitus position, depending on the side of the surgical procedure. After the T10 spinous process is identified by manual examination, sterile conditions will be established. The transverse process and erector spinae muscles will be visualized using an ultrasound probe. Using an in-plane technique, 20 ml of 0.25% bupivacaine will be injected between the transverse process and erector spinae muscles using a 22-gauge blocking needle.

erectör spinae plane block

Quadratus Lumborum (QL) Block OTHER

Following standard anesthesia monitoring, patients will be placed in the lateral decubitus position. After the field is sterilized, a 2-5 MHz convex ultrasound probe (Samsung, HM70 EVO) will be placed between the iliac crest and costal arch at the level of the posterior axillary line. The transverse process of the L4 vertebra, erector spinae, QL, and PM muscles will be visualized. After inducing local anesthesia with 2% lidocaine (2 ml), a blocking needle (22G\*100 mm, Braun) will be advanced from posterolateral to anteromedial, inserting it between the QL and PM muscles, and 20 ml of 0.25% bupivacaine will be injected.

Transmuskuler quadratus lumborum block

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Renal transplantation
• Patients between the ages of 18-65

You may not qualify if:

• Patients who do not agree to participate in the study,
• Patients havecoagulopathy, liver function problems, local anesthetic allergy
• Body mass index (BMI) \> 40

Sponsors & Collaborators

• Kocaeli Derince Education and Research Hospital: lead

Study Sites (1)

Kartal Dr Lutfi Kirdar City Hospital

Istanbul, Kartal, 34000, Turkey (Türkiye)

Location

MeSH Terms

Interventions

Parapsychology; Dental Occlusion; Bupivacaine

Intervention Hierarchy (Ancestors)

Behavioral Sciences; Behavioral Disciplines and Activities; Dentistry; Dental Physiological Phenomena; Digestive System and Oral Physiological Phenomena; Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: ASSOCİATED PROFESSOR

Study Record Dates

• First Submitted: June 23, 2025
• First Posted: July 10, 2025
• Study Start: March 25, 2025
• Primary Completion: August 30, 2025
• Study Completion: September 30, 2025
• Last Updated: January 16, 2026

Record last verified: 2025-06

Locations

TU (1)