Quadro-Iliac Plane Block for Pain Control After Posterior Spinal Instrumentation Surgery

NCT07711522 | Not Yet Recruiting Early Phase 1

• 1 other identifier: PSEQIPB2026
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Posterior spinal instrumentation can cause significant postoperative pain due to extensive muscle dissection, manipulation of bone tissue, and implant placement. Providing optimal analgesia in the postoperative period is important for patients' functional recovery and early mobilization. Inadequate control of postoperative pain may delay recovery, increase the risk of opioid dependence, and lead to respiratory complications. Although opioid analgesics are effective in reducing pain during the postoperative period, they are associated with side effects such as nausea, vomiting, respiratory depression, and the risk of dependence. Therefore, the use of non-opioid analgesic approaches is important for patient safety and comfort. For these reasons, regional analgesia techniques such as the modified thoracolumbar interfascial plane (TLIP) block and the erector spinae plane (ESP) block have recently become increasingly popular for postoperative pain control. The quadro-iliac plane block is a novel technique that targets the attachment area of the posterior surface of the quadratus lumborum muscle on the inner surface of the iliac crest. In this block, the spread of local anesthetic along the fascial planes surrounding the quadratus lumborum muscle may provide an anatomical mechanism contributing to analgesia of the lumbosacral, paraspinal, lower abdominal, and gluteal regions. However, as the quadro-iliac plane block is a new technique, there are not yet sufficient studies on this topic in the literature. The primary objective of our study is to evaluate the effect of ultrasound-guided quadro-iliac plane block (QIPB) on postoperative opioid consumption after posterior spinal instrumentation. The secondary objectives are to compare opioid-related side effects, such as nausea, vomiting, and respiratory depression, as well as postoperative NRS (Numeric Rating Scale) pain scores between the groups.

Conditions

Posterior Spinal Instrumentation Patients

Keywords

Posterior spinal instrumentation; Postoperative analgesia; quadro-iliac plane block

Outcome Measures

Primary Outcomes (1)

• The effect of ultrasound-guided quadro-iliac plane block (QIPB) on postoperative opioid consumption f

  The primary objective of this study is to evaluate the effect of ultrasound-guided quadro-iliac plane block (QIPB) on postoperative opioid consumption following posterior spinal instrumentation surgery.

  Postoperative 24 hours

Secondary Outcomes (2)

• NRS of patients

  Postoperative 24 hours

• Opioid related adverse effects

  Postoperative 24 hours

Study Arms (2)

Quadro-iliac block group

ACTIVE COMPARATOR

Drug: Fentanyl (IV); Drug: Meperidine; Drug: Paracetamol (acetaminophen)

Wound infiltration Group

OTHER

Drug: Fentanyl (IV); Drug: Meperidine; Drug: Paracetamol (acetaminophen)

Interventions

Meperidine DRUG

If the patient's NRS is 4 or more even though 1 gr IV paracetamol and IV PCA, meperidine 0.5 mg/kg w'll be administered as rescue analgesic

Quadro-iliac block group; Wound infiltration Group

Fentanyl (IV) DRUG

All patients will have an IV PCA with fentanyl.The PCA settings will consist of a 10-µg fentanyl bolus dose with a 10-minute lockout interval.

Quadro-iliac block group; Wound infiltration Group

Paracetamol (acetaminophen) DRUG

An order for intravenous paracetamol 1 g every 8 hours will be placed for all patients.

Quadro-iliac block group; Wound infiltration Group

Eligibility Criteria

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

Sponsors & Collaborators

• Istanbul Medipol University Hospital: lead

Study Sites (1)

Medipol Mega Hastaneler Kompleksi

Istanbul, Bagcilar, 34214, Turkey (Türkiye)

Location

Related Publications (3)

• 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 RESULT

• 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 RESULT

• Zamudio D, Fernandez L, Rodriguez A, Delgado D. Postoperative erector spinae plane block does not reduce morphine consumption after lumbar spinal fusion: A randomized controlled trial. J Clin Anesth. 2025 Nov;107:112022. doi: 10.1016/j.jclinane.2025.112022. Epub 2025 Sep 26.

  PMID: 41014734 RESULT

MeSH Terms

Interventions

Fentanyl; Meperidine; Acetaminophen

Intervention Hierarchy (Ancestors)

Piperidines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Isonipecotic Acids; Acids, Heterocyclic; Acetanilides; Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines

Central Study Contacts

Fatma P Ucar

CONTACT

+90 537 769 72 81; fpinarucar@gmail.com

Study Design

• Study Type: interventional
• Phase: early phase 1
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: M.D.

Study Record Dates

• First Submitted: July 14, 2026
• First Posted: July 17, 2026
• Study Start: August 1, 2026
• Primary Completion (Estimated): July 1, 2027
• Study Completion (Estimated): July 1, 2027
• Last Updated: July 17, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)