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

March 5, 2026 updated by: Merih Yıldız Eglen, Bursa City Hospital

Evaluation of the Effectiveness of Ultrasound-Guided Quadro-Iliac Plane Block in Postoperative Analgesia Management Following Lumbar Instrumentation Surgery

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.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Lumbar instrumentation surgery is associated with significant postoperative pain, which may reduce patient comfort, delay early mobilization, and increase analgesic requirements. Effective postoperative pain management is essential for enhancing recovery and reducing postoperative morbidity. In this context, regional anesthesia techniques have become an important component of multimodal analgesia strategies.

The Quadro-Iliac Plane Block is a newly described ultrasound-guided regional analgesia technique. This block aims to provide effective analgesia by targeting the relevant branches of the lumbar nerves supplying the surgical area. However, clinical evidence regarding its effectiveness in postoperative analgesia following lumbar instrumentation surgery remains limited.

This study aims to evaluate the postoperative analgesic effectiveness of the ultrasound-guided Quadro-Iliac Plane Block in patients undergoing lumbar instrumentation surgery. The findings of this study are expected to contribute to the assessment of this newly developed technique as a safe and effective option for postoperative pain management in lumbar spine surgery.

Study Type

Interventional

Enrollment (Estimated)

80

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 Contact

Study Contact Backup

  • Name: Merih Yıldız Eglen, MD
  • Phone Number: +905059340629
  • Email: Meriheg@yahoo.com

Study Locations

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • 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

Exclusion Criteria:

  • 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

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
No Intervention: Group Control
Active Comparator: Group QIPB

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

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative 48-Hour PCA Opioid Consumption
Time Frame: Postoperative 0-8, 8-16, 16-24, 24-48 intervals
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
Time Frame: Postoperative 24th and 48th hours

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 Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total rescue analgesic dose
Time Frame: Postoperative 24th and 48th hours

Despite the use of patient-controlled analgesia (PCA), if the Numeric Rating Scale (NRS) score is ≥4 at any time point, 0.5 mg/kg intravenous meperidine will be administered as rescue analgesia.

Total amount of meperidin during the first 24 and 48 hours after surgery, recorded in milligrams (mg).
Postoperative 24th and 48th hours
Dynamic and static NRS scores
Time Frame: 0, 2, 4, 8, 16, 24, and 48 hours postoperatively
Numeric Rating Scale (NRS) (0-10) pain scores at rest or movement at predefined postoperative hours
0, 2, 4, 8, 16, 24, and 48 hours postoperatively
Time of first request for rescue analgesia
Time Frame: Postoperative 48-Hours
Despite the use of patient-controlled analgesia (PCA), if the Numeric Rating Scale (NRS) score is ≥4 at any time point, 0.5 mg/kg intravenous meperidine will be administered as rescue analgesia.
Postoperative 48-Hours
Length of Hospital Stay
Time Frame: 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).
Length of hospital stay will be defined as the number of days from the end of surgery to hospital discharge.
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
Time Frame: Postoperative 48-Hours
Block- and opioid-related adverse effects and complications, including but not limited to local anesthetic toxicity, hematoma, infection, nerve injury, nausea, vomiting, pruritus, sedation, and respiratory depression, will be recorded
Postoperative 48-Hours

Collaborators and Investigators

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

Sponsor

Bursa City Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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 20, 2026

Primary Completion (Estimated)

March 31, 2026

Study Completion (Estimated)

July 1, 2026

Study Registration Dates

First Submitted

December 26, 2025

First Submitted That Met QC Criteria

January 22, 2026

First Posted (Actual)

January 27, 2026

Study Record Updates

Last Update Posted (Actual)

March 6, 2026

Last Update Submitted That Met QC Criteria

March 5, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • BursaCityHOS 1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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.

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