Anterior QLB for PCNL

March 17, 2026 updated by: Gülbeyaz Yalçın, Zonguldak Bulent Ecevit University

Perioperative Analgesia Management in Patients Undergoing Percutaneous Nephrolithotomy Following Anterior Quadratus Lumborum Block

Aim: In this study, we primarily aimed to determine the effect of anterior Quadratus Lumborum Block (QLB) on intraoperative and postoperative opioid consumption in patients undergoing percutaneous nephrolithotomy (PCNL) surgery under general anesthesia. Secondarily, we aimed to evaluate opioid-related complications and investigate the impact of anterior QLB on the quality of postoperative recovery using the QoR-15 (Quality of Recovery-15) questionnaire.

Materials and Methods: The study included 60 patients aged 18-75, with ASA physical status I-III, who were scheduled for elective PCNL. Patients were randomly assigned to either the Control Group (n=30) or the Anterior QLB Group (n=30). Following dropouts during follow-up, a total of 54 patients (27 in each group) were analyzed. Preoperative block was performed in the Anterior QLB group. In both groups, following anesthesia induction, anesthesia maintenance was provided with sevoflurane to maintain a BIS value of 40-60, and the remifentanil dosage was adjusted to keep the ANI between 50-70. Operation time, surgical duration, extubation time, intraoperative hemodynamic data, ANI values, and the amount of intraoperative remifentanil consumed were recorded. Postoperative recovery unit pain scores, incidence of nausea and vomiting, and additional analgesic requirements were documented. Pain scores at the 1st, 2nd, 6th, 12th, and 24th postoperative hours, postoperative complications (nausea, vomiting, etc.), opioid consumption, and the results of the QoR-15 questionnaire at the 24th hour were recorded.

Results: Intraoperative remifentanil consumption, both in terms of total dose and weight-adjusted infusion rate, was significantly lower in the Anterior QLB group (p<0.001). Pain scores were significantly lower in the Anterior QLB group both in the recovery unit and at all postoperative time points (p<0.05). Postoperative cumulative tramadol consumption was also lower in the Anterior QLB group across all time intervals (p<0.05). No significant difference was found between the two groups regarding the incidence of postoperative nausea and vomiting. Furthermore, no significant difference was observed in the QoR-15 questionnaire scores evaluated at the 24th postoperative hour.

Conclusion: Anterior QLB is an effective analgesic method in percutaneous nephrolithotomy surgery, reducing perioperative opioid consumption and postoperative pain scores. It is concluded that anterior QLB is effective as a significant component of the multimodal analgesia strategy by preventing potential side effects associated with opioid consumption.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

54

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

  • Turkey (Türkiye)
    • Zonguldak Province
      • Zonguldak, Zonguldak Province, Turkey (Türkiye)
        • Zonguldak Bulent Ecevit University Hospital

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:

  • Age between 18 and 75 years.
  • American Society of Anesthesiologists (ASA) physical status I-III.
  • Patients undergoing percutaneous nephrolithotomy (PCNL) under general anesthesia

Exclusion Criteria:

  • Known allergy to local anesthetics.
  • Coagulopathy or bleeding disorders.
  • Infection at the site of intervention.
  • Neurological or neuromuscular diseases.
  • Psychiatric disorders.
  • Chronic pain syndromes.
  • Chronic analgesic or opioid use.
  • History of opioid abuse.
  • Contraindications to regional anesthesia.
  • Cardiac dysrhythmia that could interfere with Analgesia Nociception Index (ANI) monitoring.
  • Patients requiring vasoactive or chronotropic drugs (e.g., atropine, ephedrine, nitroglycerin, or noradrenaline) to maintain hemodynamic stability during surgery.
  • Refusal to participate in the study.

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: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: group control
patients receive standart general anesthesia
Active Comparator: group anterior QLB
Patients receiving and ultrasound guided anterior quadratus lumborum block in addition to general anesthesia before surgery
Procedure: ANTERİOR QUADRATUS LUMBORUM BLOCK ( anterior QLB)
injection local anesthetic between quadratus lumborum and psaos major

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
intraoperative and total postoperative opioid consumption in the first 24 hours
Time Frame: first 24 hours after surgery
primary aimed to determine the effect of anterior Quadratus Lumborum Block (QLB) on intraoperative and postoperative opioid consumption in patients undergoing percutaneous nephrolithotomy (PCNL) surgery under general anesthesia.
first 24 hours after surgery

Secondary Outcome Measures

Outcome Measure
Time Frame
Quallty of recovery by using QoR-15 questionnaire
Time Frame: postoperative 24th hour
postoperative 24th hour
evaluate opioid-related complications
Time Frame: postoperative 0, 1, 2, 6, 12, 24 th hour
postoperative 0, 1, 2, 6, 12, 24 th hour

Collaborators and Investigators

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

Sponsor

Zonguldak Bulent Ecevit University

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)

May 1, 2024

Primary Completion (Actual)

October 1, 2025

Study Completion (Actual)

October 1, 2025

Study Registration Dates

First Submitted

March 17, 2026

First Submitted That Met QC Criteria

March 17, 2026

First Posted (Actual)

March 23, 2026

Study Record Updates

Last Update Posted (Actual)

March 23, 2026

Last Update Submitted That Met QC Criteria

March 17, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 2024/08-3

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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