QLESP Block for Pain Control in Robotic Partial Nephrectomy

NCT07704970 | Not Yet Recruiting

• 1 other identifier: WHUH20260711
• Study Type: interventional
• Target: 120
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to learn if an ultrasound-guided nerve block called QLESP works to reduce pain and the need for strong pain medicines after robotic kidney surgery in adults. The main questions it aims to answer are:

1. 1.Does QLESP reduce the total amount of opioid pain medicine participants need in the first 48 hours after surgery?
2. 2.Does QLESP lower pain scores and improve recovery quality after surgery? Researchers will compare participants who receive QLESP block to participants who receive the same numbing medicine injected only at the surgical wound sites.
3. 3.Be randomly assigned to receive either QLESP or local wound injection before surgery.
4. 4.Have a patient-controlled pain pump for 48 hours after surgery.
5. 5.Complete pain scores and recovery quality questionnaires at 2, 6, 12, 24, 48, and 72 hours after surgery.
6. 6.Be followed until hospital discharge.

Conditions

Renal Cell Carcinoma (Kidney Cancer); Postoperative Pain; Nerve Block

Keywords

Quadratus Lumborum Block; Erector Spinae Plane Block; Robot-Assisted Partial Nephrectomy; Postoperative Pain; Enhanced Recovery After Surgery

Outcome Measures

Primary Outcomes (1)

• Cumulative Opioid Consumption at 48 Hours Postoperatively

  Cumulative opioid consumption measured at 48 hours after surgery

  From the end of surgery to 48 hours postoperatively.

Study Arms (2)

QLESP Group

EXPERIMENTAL

Participants receive ultrasound-guided QLESP block with 30 mL of 0.375% ropivacaine (15 mL in the erector spinae fascial plane and 15 mL in the quadratus lumborum-psoas major interfascial plane) after induction of general anesthesia.

Drug: ropivacaine

Control Group

ACTIVE COMPARATOR

Participants receive local wound infiltration with 30 mL of 0.375% ropivacaine at the port sites performed by the surgeon at the end of surgery.

Drug: ropivacaine (local infiltration)

Interventions

ropivacaine (local infiltration) DRUG

Ultrasound-guided QLESP block with 30 mL of 0.375% ropivacaine (15 mL injected between the erector spinae muscle and the transverse process at L2 level, followed by 15 mL injected between the quadratus lumborum and psoas major muscles) after induction of general anesthesia.

Control Group

ropivacaine DRUG

Local wound infiltration with 30 mL of 0.375% ropivacaine at the port sites performed by the surgeon at the end of surgery.

QLESP Group

Eligibility Criteria

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

You may qualify if:

• Aged 18 to 75 years
• Scheduled for elective robot-assisted partial nephrectomy (RAPN)
• American Society of Anesthesiologists (ASA) physical status I to III
• Body mass index (BMI) 18 to 35 kg/m²
• Voluntarily signed informed consent form Able to understand pain scoring and use of patient-controlled analgesia (PCA)

You may not qualify if:

• Language, communication, or comprehension barriers
• Infection at the intended puncture site
• Coagulopathy or bleeding diathesis
• Known allergy or contraindication to local anesthetics or opioids
• Use of analgesic medications within the past 3 months
• Peripheral neuropathy
• Severe cardiac, hepatic, or renal dysfunction
• Pregnancy or breastfeeding
• Refusal to participate in the study

Sponsors & Collaborators

• Huazhong University of Science and Technology: lead

Study Sites (1)

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Wuhan, Hubei, 430022, China

Location

Related Publications (4)

• Elsharkawy H, Bajracharya GR, El-Boghdadly K, Drake RL, Mariano ER. Comparing two posterior quadratus lumborum block approaches with low thoracic erector spinae plane block: an anatomic study. Reg Anesth Pain Med. 2019 Mar 28:rapm-2018-100147. doi: 10.1136/rapm-2018-100147. Online ahead of print.

  PMID: 30923253 RESULT

• Kadam VR, Van Wijk RM, Ludbrook GL, Thiruvenkatarajan V. Anatomical and ultrasound description of two transmuscular quadratus lumborum block approaches at L2 level and their application in abdominal surgery. Anaesth Intensive Care. 2019 Mar;47(2):141-145. doi: 10.1177/0310057X19839931. Epub 2019 May 15.

  PMID: 31088120 RESULT

• Little C, Rahman S. Quadratus Lumborum Blocks in Nephrectomy: A Narrative Review. Local Reg Anesth. 2021 Apr 19;14:57-65. doi: 10.2147/LRA.S290224. eCollection 2021.

  PMID: 33907461 RESULT

• He Y, Huang M, Zhong Q, Ni H, Yu Z, Zhang X. Analgesic Effect of Ultrasound-Guided Anterior Quadratus Lumborum Block at the L2 Level in Patients Undergoing Laparoscopic Partial Nephrectomy: A Single-Center, Randomized Controlled Trial. Pain Res Manag. 2022 Dec 15;2022:8958859. doi: 10.1155/2022/8958859. eCollection 2022.

  PMID: 36569463 RESULT

MeSH Terms

Conditions

Carcinoma, Renal Cell; Kidney Neoplasms; Pain, Postoperative

Interventions

Ropivacaine

Condition Hierarchy (Ancestors)

Adenocarcinoma; Carcinoma; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms; Urologic Neoplasms; Urogenital Neoplasms; Neoplasms by Site; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Kidney Diseases; Urologic Diseases; Male Urogenital Diseases; Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Intervention Hierarchy (Ancestors)

Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines

Central Study Contacts

Xi Wu

CONTACT

+8615871715431; wu2018whuh@163.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: This is a double-blind trial. Participants are blinded to group allocation through standardized pre-procedure communication and identical positioning, preparation, and needling sensation across both groups. Postoperative outcome assessors are blinded and do not have access to the randomization system or block procedure records; data are collected using uniform time windows. The anesthesiologist performing the block is not blinded due to the nature of the intervention but does not participate in postoperative follow-up or outcome assessment. The intraoperative anesthesia manager is blinded to group assignment and does not review block records. The statistician will remain blinded until database lock. The surgeon performing local wound infiltration in the control group is not involved in the randomization or block procedure.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: July 11, 2026
• First Posted: July 15, 2026
• Study Start: July 20, 2026
• Primary Completion (Estimated): February 28, 2027
• Study Completion (Estimated): March 31, 2027
• Last Updated: July 16, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)