Quadratus Lumborum Block, Transversus Abdominis Plane Block, and Erector Spinae Block in Pediatric Abdominal Surgery

September 23, 2026 updated by: Ahmed Hassan Ahmed Tawfeek, Menoufia University

Comparing Quadratus Lumborum Block, Transversus Abdominis Plane Block, and Erector Spinae Block in Pediatric Abdominal Surgery

The aim of this study is to compare the analgesic efficacy and safety of Quadratus Lumborum (QL), Transversus Abdominis Plane (TAP), and Erector Spinae Plane (ESP) blocks in pediatric abdominal surgery.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Advances in perioperative care of children continue to be made with increasing evidence-based practice for postoperative analgesia. However, moderate to severe pain is still experienced by up to 40% of hospitalized children and specific high-risk populations or types of surgery continue to present challenges.

Transversus abdominis plane (TAP) block involves the injection of local anesthesia (LA) in between the transversus abdominis (TA) and internal oblique (IO) muscles.

The Erector Spinae Plane (ESP) block is most often performed using an in-plane ultrasound-guided technique. It is a paraspinal fascial plane block in which the needle placement is between the erector spinae muscle and the thoracic transverse processes, and a local anesthetic is administered, blocking the dorsal and ventral rami of the thoracic and abdominal spinal nerves.

Study Type

Interventional

Enrollment (Actual)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Menoufia
      • Shibīn al Kawm, Menoufia, Egypt, 32951
        • Menoufia University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

3 years to 12 years (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Children aged from 3 to12 years.
  • Both sexes.
  • American Society of Anesthesiologists (ASA) Physical Status I-II.
  • Scheduled for pediatric abdominal surgery.

Exclusion Criteria:

  • Allergy or contraindication to bupivacaine or dexmedetomidine.
  • Coagulopathy.
  • Local infection at the site of the block.
  • Neurological or psychiatric disorders affecting pain perception.
  • Refusal of the regional technique by parents/guardians.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: QL Group

Patients received quadratus lumborum (QL) block with bupivacaine 0.25% (0.5 ml/kg) + dexmedetomidine 0.5 mcg/kg.

Patients received quadratus lumborum (QL) block with bupivacaine 0.25% (0.5 ml/kg) + dexmedetomidine 0.5 mcg/kg.

Other Names:
  • Bupivacaine 0.25% (0.5 ml/kg) + dexmedetomidine 0.5 mcg/kg
Experimental: TAP group

Patients received transversus abdominis plane (TAP) block with bupivacaine 0.25% (0.5 ml/kg) + dexmedetomidine 0.5 mcg/kg

Patients received transversus abdominis plane (TAP) block with bupivacaine 0.25% (0.5 ml/kg) + dexmedetomidine 0.5 mcg/kg.

Other Names:
  • Bupivacaine 0.25% (0.5 ml/kg) + dexmedetomidine 0.5 mcg/kg
Experimental: ES Group

Patients received erector spinae plane (ESP) block with bupivacaine 0.25% (0.5 ml/kg) + dexmedetomidine 0.5 mcg/kg.

Patients received erector spinae plane (ESP) block with bupivacaine 0.25% (0.5 ml/kg) + dexmedetomidine 0.5 mcg/kg.

Other Names:
  • Bupivacaine 0.25% (0.5 ml/kg) + dexmedetomidine 0.5 mcg/kg

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Degree of pain
Time Frame: 24 hours postoperatively

Degree of pain will be assessed using Wong-Baker FACES for the first 24 hours postoperative at 4, 8,12,16 and 24 hours postoperatively.

Wong-Baker FACES Pain Scale, which utilizes a series of 6 faces increasing in pain severity may be used to facilitate communication and assist in pain assessment .

24 hours postoperatively

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total fentanyl consumption
Time Frame: Intraoperatively

If patient require analgesia during surgery (diagnosed by increasing heart rate and blood pressure) fentanyl 1mic/kg will be given, and total analgesic consumption will be calculated and recorded.

Intraoperatively
Heart rate
Time Frame: Till the end of surgery (Up to 2 hours)

Heart rate will be recorded every 15 minutes till the end of surgery.

Till the end of surgery (Up to 2 hours)
Mean arterial blood pressure
Time Frame: Till the end of surgery (Up to 2 hours)

Mean arterial blood pressure will be recorded every 15 minutes till the end of surgery.

Till the end of surgery (Up to 2 hours)
Time of each block
Time Frame: Intraoperatively

Time of each block will be recorded from using ultrasound probe till injection of local anaesthetic

Intraoperatively
Sedation score
Time Frame: 24 hours postoperatively

Sedation score will be recorded at 0, 15 min ,30 min postoperative 0=no sedation (wide awake).

=slightly sedated (easy to arouse) 2=moderately sedated(easy to arouse but cannot stay awake) 3=heavy sedated (difficult to arouse)

24 hours postoperatively
Time to first rescue analgesia
Time Frame: 24 hours postoperatively

Time to first rescue analgesia will be recorded from the end of surgery till first dose of morphine administrated.

24 hours postoperatively
Total morphine consumption
Time Frame: 24 hours postoperatively

If the pain score more than or equal to 4), opioid (morphine) 0.5 to 1 mg/kg will be given and total dose will be calculated

24 hours postoperatively
Incidence of postoperative complications
Time Frame: 24 hours postoperatively

Incidence of postoperative complications such as hypotension, nausea and vomiting will be recorded.

24 hours postoperatively

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2025

Primary Completion (Actual)

June 1, 2026

Study Completion (Actual)

June 1, 2026

Study Registration Dates

First Submitted

September 23, 2026

First Submitted That Met QC Criteria

September 23, 2026

First Posted (Actual)

September 30, 2026

Study Record Updates

Last Update Posted (Actual)

September 30, 2026

Last Update Submitted That Met QC Criteria

September 23, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 12/2024 ANET 32

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The data will be available upon a reasonable request from the corresponding author after the end of study for one year.

IPD Sharing Time Frame

After the end of study for one year.

IPD Sharing Access Criteria

The data will be available upon a reasonable request from the corresponding author.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.