Comparison of ESP and QL Blocks for Postoperative Pain in Pediatric Appendectomy (ESP-QLB)

NCT07301528 | Completed

• 1 other identifier: KSBU-ESPQL-2026
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 2

Brief Summary

This prospective randomized controlled clinical trial aims to compare the analgesic effectiveness of the Erector Spinae Plane (ESP) block and the Quadratus Lumborum (QL) block in pediatric patients undergoing appendectomy. Both regional anesthesia techniques have been shown to reduce opioid requirements and improve postoperative recovery in children; however, there is limited evidence directly comparing their efficacy. In this study, eligible participants will be randomly assigned to receive either an ESP or a QL block in addition to standard general anesthesia before surgical incision. Postoperative outcomes will include pain scores, total opioid consumption, time to first analgesic requirement, mobilization time, parental satisfaction, length of hospital stay, block-related complications and block performance time. The findings are expected to guide clinicians in selecting the most effective regional anesthesia technique for postoperative pain control in pediatric appendectomy.

Conditions

Quadratus Lumborum Nerve Block; Erector Spinae Block

Keywords

Erector Spinae Plane Block; Quadratus Lumborum Block; Regional Anesthesia; Pediatric Appendectomy; Postoperative Pain; Ultrasound-Guided Nerve Blocks; Analgesic Requirement

Outcome Measures

Primary Outcomes (1)

• Postoperative Pain Score

  Pain intensity will be evaluated at rest using the Oucher Pain Rating Scale. Higher scores indicate greater pain.

  Pain scores will be assessed at 1, 6, 12, and 24 postoperative hours.

Secondary Outcomes (7)

• Total Analgesic Consumption

  Recorded during the first 24 hours after surgery

• Time to First Analgesic Requirement

  From the end of surgery until the first documented analgesic requirement, assessed up to 24 hours postoperatively

• Time to Mobilization

  From the end of surgery until the first successful ambulation with or without assistance, assessed up to 24 hours postoperatively

• Length of Hospital Stay

  From the end of surgery until hospital discharge, typically within 24-48 hours.

• Parents' Postoperative Pain Measure (PPPM)

  Assessed at 1, 6, 12, and 24 hours postoperatively

Study Arms (2)

QLB Block

EXPERIMENTAL

Ultrasound-guided transmuscular QL block using 0.25% bupivacaine (0.5 mL/kg) before surgical incision.

Drug: Quadratus Lumborum Block (QLB)

ESP Block

ACTIVE COMPARATOR

Ultrasound-guided ESP block at the L1 level using 0.25% bupivacaine (0.5 mL/kg) before surgical incision.

Drug: Erector Spinae Plane Block

Interventions

Quadratus Lumborum Block (QLB) DRUG

Ultrasound-guided transmuscular QL block performed under general anesthesia using 0.25% bupivacaine (0.5 mL/kg) before surgical incision.

QLB Block

Erector Spinae Plane Block DRUG

Ultrasound-guided ESP block at the L1 level under general anesthesia using 0.25% bupivacaine (0.5 mL/kg) before surgical incision.

ESP Block

Eligibility Criteria

• Age: 3 Years - 13 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Patients aged 3-13 years
• Diagnosis of acute appendicitis requiring appendectomy
• ASA physical status I-II
• Planned general anesthesia with intraoperative regional block (ESP or QL block)
• Written informed consent obtained from parents or legal guardians

You may not qualify if:

• Refusal of regional block by family or anesthesia team
• Coagulopathy or anticoagulant medication use
• Local infection at the block injection site
• Known allergy or contraindication to local anesthetics
• Neurological or neuromuscular disorders
• Cognitive impairment preventing postoperative pain assessment
• Conversion to open surgery
• Intraoperative complications requiring deviation from study protocol

Sponsors & Collaborators

• Zeycan Kahya: lead

Study Sites (2)

Kutahya City Hospital Anesthesia and Reanimation Department

Kütahya, Kütahya, 43100, Turkey (Türkiye)

Location

Kutahya City Hospital

Kütahya, 43100, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

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

Study Officials

• Süleyman Camgöz

  Kutahya Health Sciences University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Medicine of Doctor

Model Details: Participants will be randomly assigned in a 1:1 ratio to one of two parallel intervention arms: ultrasound-guided Erector Spinae Plane block or ultrasound-guided Quadratus Lumborum block, both performed under general anesthesia before surgical incision.

Study Record Dates

• First Submitted: November 16, 2025
• First Posted: December 24, 2025
• Study Start: December 13, 2025
• Primary Completion: April 15, 2026
• Study Completion: April 28, 2026
• Last Updated: May 5, 2026

Record last verified: 2026-04

Locations

TU (2)