US-Guided Quadro-Iliac Plane Block for Postoperative Analgesia After Lumbar Instrumentation

NCT07370428 | Recruiting

• 1 other identifier: BursaCityHOS 1
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

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.

Conditions

Postoperative Pain

Keywords

Quadro-Iliac Plane Block; Lumbar Instrumentation Surgery; Pain Management

Outcome Measures

Primary Outcomes (2)

• Postoperative 48-Hour PCA Opioid Consumption

  Total amount of opioid delivered by the patient-controlled analgesia (PCA) device during the first 48 hours after surgery, recorded in milligrams (mg).

  Postoperative 0-8, 8-16, 16-24, 24-48 intervals

• QoR-15 Recovery Score

  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

  Postoperative 24th and 48th hours

Secondary Outcomes (5)

• Dynamic and static NRS scores

  0, 2, 4, 8, 16, 24, and 48 hours postoperatively

• Total rescue analgesic dose

  Postoperative 24th and 48th hours

• Time of first request for rescue analgesia

  Postoperative 48-Hours

• 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).

• Block and Opioid-Related Adverse Effects and Complications

  Postoperative 48-Hours

Study Arms (2)

Group QIPB

ACTIVE COMPARATOR

Participants in this arm will receive an ultrasound-guided Quadro-Iliac Plane Block. The block will be performed at the end of surgery, before extubation, with the patient in the prone position under standard sterilization conditions. A convex ultrasound probe will be placed at the level where the quadratus lumborum muscle (QLM) attaches to the iliac crest to visualize the erector spinae muscle (ESM) and the underlying QLM. The block location will be confirmed by injecting 2 mL of isotonic solution at the QLM-iliac crest junction. Subsequently, 20 mL of 0.25% bupivacaine will be injected, and the spread of the local anesthetic between the ESM and QLM will be observed under ultrasound guidance. The block will be performed bilaterally with a total volume of 40 mL.

Procedure: Quadro-Iliac Plane Block

Group Control

NO INTERVENTION

Interventions

Quadro-Iliac Plane Block PROCEDURE

Ultrasound-guided regional anesthesia technique performed between the erector spinae muscle and the quadratus lumborum muscle at the iliac crest level.

Group QIPB

Eligibility Criteria

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

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Bursa City Hospital: lead

Study Sites (1)

Bursa City Hospital

Bursa, 16110, Turkey (Türkiye)

RECRUITING

Related Publications (3)

• Tulgar S, Ciftci B, Ahiskalioglu A, Bilal B, Sakul BU, Girit M, Akin T, Narayanan M, Alici HA. Ultrasound guided quadro-iliac plane block: another novel fascial plane block. Pain Med. 2024 May 3;25(6):370-373. doi: 10.1093/pm/pnae018.

  PMID: 38459608 BACKGROUND

• Turan EI, Sahin AS. Quadro-iliac plane block (QIPB) in lumbar stabilisation surgeries: A case series. Indian J Anaesth. 2025 Feb;69(2):244-245. doi: 10.4103/ija.ija_1077_24. Epub 2025 Jan 29. No abstract available.

  PMID: 40160919 BACKGROUND

• Ciftci B, Cetinkal A, Alver S, Ahiskalioglu A. Quadro-iliac plane block for lumbar multi-level instrumentation surgery: far away from the surgical area. Minerva Anestesiol. 2025 Apr;91(4):358-359. doi: 10.23736/S0375-9393.24.18680-4. Epub 2024 Dec 10. No abstract available.

  PMID: 39656149 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative; Agnosia

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms; Perceptual Disorders; Neurobehavioral Manifestations; Nervous System Diseases

Central Study Contacts

Mursel Ekinci, Assoc prof,MD

CONTACT

+905067137596; drmurselekinci@gmail.com

Merih Yıldız Eglen, MD

CONTACT

+905059340629; meriheg@yahoo.com

Study Design

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

Study Record Dates

• First Submitted: December 26, 2025
• First Posted: January 27, 2026
• Study Start: January 20, 2026
• Primary Completion: March 31, 2026
• Study Completion (Estimated): July 1, 2026
• Last Updated: March 6, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)