mTLIP vs QIPB for Postoperative Analgesia in Lumbar Microdiscectomy Surgery

NCT07480278 | Recruiting

• 1 other identifier: BursaCityHOS 5
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this prospective randomized clinical study is to compare the analgesic efficacy and side effects of modified thoracolumbar interfascial plane block and quadroiliac plane block applied preoperatively in patients undergoing lumbar microdiscectomy surgery.The study will include a total of 80 patients aged 18-65 years with ASA I-III, with 40 patients in each group( Group mTLIP and Group QIPB) undergoing lumbar microdiscectomy surgery. The primary objective of the study is to compare groups in terms of PCA opioid consumption during the 48-hour postoperative period. Secondary objectives are to compare groups in terms of QoR-15 recovery score, dynamic and static numerical rating scale scores, total rescue analgesic use, time to first request for rescue analgesia, length of hospital stay, block and opioid-related side effects and complications, and perioperative remifentanil infusion dose.

Conditions

Postoperative Pain Management

Keywords

Postoperative pain; Quadro-iliac plane block; Lumbar Microdiscectomy; Modified thoracolumbar interfascial plane block

Outcome Measures

Primary Outcomes (1)

• 1. Postoperative 48-Hour PCA Opioid Consumption

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

  Time Frame: Postoperative 0-8, 8-16, 16-24 24-48 hours intervals

Secondary Outcomes (7)

• QoR-15 Recovery Score

  Postoperative 24th and 48th hours

• Dynamic and static Numeric Rating Scale scores

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

• Total rescue analgesic dose

  Time Frame: Postoperative 48 hours

• Time of first request for rescue analgesia

  Time Frame: Postoperative 48 hours

• Length of Hospital Stay

  the day of discharge from the hospital (assessed up to 10 days)

Study Arms (2)

Group mTLIP

EXPERIMENTAL

Patients in this group will undergo bilateral mTLIP block under ultrasound guidance prior to surgery.

Procedure: Modified Thoracolumbar Interfascial Plane Block (mTLIP)

Group QIPB

EXPERIMENTAL

Patients in this group will undergo bilateral QIPB block under ultrasound guidance prior to surgery.

Procedure: Quadro-Iliac Plane Block (QIPB)

Interventions

Modified Thoracolumbar Interfascial Plane Block (mTLIP) PROCEDURE

This is a fascial plane block in which a local anesthetic is injected into the interfascial plane between the longissimus and iliocostalis muscles. Participants in this group will undergo bilateral modified thoracolumbar interfascial plane blocks (mTLIP) under ultrasound guidance prior to surgery. Under sterile conditions, with the patient in the prone position, the ultrasound probe will be placed in the parasagittal plane at the midpoint of the surgical incision, taking into account the lumbar levels to be operated on. The paraspinal muscles will be identified, and using an in-plane technique, the needle will be advanced into the interfascial plane between the longissimus and iliocostalis muscles. Correct needle placement will be confirmed with saline solution. A total of 40 mL of 0.25% bupivacaine and 5 µg/mL (1:200,000) adrenaline-containing local anesthetic solution (20 mL for each side) will be used for the block procedures.

Group mTLIP

Quadro-Iliac Plane Block (QIPB) PROCEDURE

This is a fascial plane block is a procedure in which local anesthetic is injected at the point where the quadratus lumborum muscle attaches to the iliac crest, allowing it to spread between the erector spinae and quadratus lumborum muscles. Participants in the QIPB Group will undergo bilateral quadrioliac plane blocks (QIPB) under ultrasound guidance prior to surgery. Under sterile conditions, with the patient in the prone position, a convex ultrasound probe will be placed at the point where the quadratus lumborum muscle attaches to the iliac crest to identify the erector spinae and quadratus lumborum muscles. After confirming the needle placement with saline, a local anesthetic solution containing 0.25% bupivacaine and 5 µg/mL (1:200,000) adrenaline will be administered, total 40 mL (20 mL for each side). The spread of the local anesthetic solution between the erector spinae and quadratus lumborum muscles will be visualized

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:

• Age between 18 and 65 years
• Classified as American Society of Anesthesiologists physical status I-III
• Scheduled for elective lumbar microdiscectomy surgery under general anesthesia
• Provision of written informed consent

You may not qualify if:

• Use of anticoagulant medications or presence of bleeding diathesis
• Known allergy or hypersensitivity to local anesthetics or opioid drugs
• Infection at the planned block site
• Alcohol or drug dependence
• Cognitive impairment preventing reliable pain assessment
• Pregnancy or lactation
• History of previous lumbar spine surgery
• Diabetes mellitus
• Renal or hepatic insufficiency

Sponsors & Collaborators

• Bursa City Hospital: lead

Study Sites (1)

Bursa City Hospital

Bursa, Nilüfer, 16110, Turkey (Türkiye)

RECRUITING

Related Publications (5)

• Turan EI, Aslan C, Berber K, Sarban O, Sahin AS. Efficacy of quadro-iliac plane block in single level lumbar discectomies: a case series for novel block. Minerva Anestesiol. 2024 Dec;90(12):1159-1160. doi: 10.23736/S0375-9393.24.18314-9. Epub 2024 Sep 11. No abstract available.

  PMID: 39258831 BACKGROUND

• Ciftci B, Ekinci M. A prospective and randomized trial comparing modified and classical techniques of ultrasound-guided thoracolumbar interfascial plane block. Agri. 2020 Nov;32(4):186-192. doi: 10.14744/agri.2020.72325.

  PMID: 33398870 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

• 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

• Alver S, Ciftci B, Celik EC, Sargolzaeimoghaddam M, Cetinkal A, Erdogan C, Ahiskalioglu A. Postoperative recovery scores and pain management: a comparison of modified thoracolumbar interfascial plane block and quadratus lumborum block for lumbar disc herniation. Eur Spine J. 2024 Jan;33(1):118-125. doi: 10.1007/s00586-023-07812-3. Epub 2023 Jun 14.

  PMID: 37314577 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

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

Central Study Contacts

Merih Yildiz Eglen, MD

CONTACT

+905059340629; meriheg@yahoo.com

Mursel Ekinci, Assoc prof MD

CONTACT

+905067137596; drmurselekinci@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: CARE PROVIDER, 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: March 9, 2026
• First Posted: March 18, 2026
• Study Start: March 25, 2026
• Primary Completion (Estimated): July 25, 2026
• Study Completion (Estimated): September 1, 2026
• Last Updated: March 27, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)