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Not yet recruiting NCT07750418

Comparison of TLIP Block and QIP Block for Postoperative Analgesia After Lumbar Spine Surgery

— Observational Lumbar Disc Herniation Postoperative Pain

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Thoracolumbar Interfascial Plane (TLIP) Block of bupivacaine, Quadratus Lumborum-Iliac Plane (QIP) Block.
Who it may be relevant to
Registry conditions: Lumbar Disc Herniation, Postoperative Pain. Basic parameters: 18 years — 65 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
Turkey (Türkiye)
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →

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Official title

Comparison of the Efficacy of Classic Thoracolumbar Interfascial Plane (TLIP) Block and Quadratus Lumborum-Iliac Plane (QIP) Block for Postoperative Analgesia in Patients Undergoing Lumbar Vertebral Surgery: A Prospective Observational Study

Overview

This study compares two regional anesthesia techniques used for pain control after lumbar spine surgery: the classic thoracolumbar interfascial plane (TLIP) block and the quadratus lumborum-iliac plane (QIP) block. Patients between 18 and 65 years of age who undergo elective lumbar discectomy (up to two spinal levels) will be observed based on which block their treating anesthesiologist chooses to use as part of routine clinical practice. No randomization or additional intervention beyond standard care will be performed. Researchers will record the total amount of opioid pain medication used in the first 24 hours after surgery, the time until the first request for pain medication, pain scores at several time points after surgery (0, 1, 2, 4, 8, 12, and 24 hours), and any side effects (such as nausea, vomiting, or sedation) or complications related to the block. The aim is to compare the effectiveness and safety of these two techniques in reducing pain and opioid use after lumbar spine surgery.

Detailed description

Patients undergoing elective lumbar discectomy at up to two levels, ASA physical status I-II, aged 18-65 years, who receive either a classic TLIP block or a QIP block as part of routine clinical anesthesia practice will be included in this prospective observational study. The choice of block technique is determined solely by the treating anesthesiologist's routine practice, not by study allocation. Both blocks are performed under ultrasound guidance at the end of surgery, before emergence from anesthesia, using bilateral injections of 20 mL (40 mL total) of 0.25% bupivacaine. All patients receive standardized general anesthesia and a multimodal analgesic regimen (intravenous paracetamol, dexketoprofen, and tramadol as rescue analgesia for VAS ≥ 4). Outcomes recorded include total opioid consumption in the first 24 postoperative hours, time to first opioid request, VAS pain scores at PACU (0h), 1, 2, 4, 8, 12, and 24 hours, postoperative side effects (nausea, vomiting, pruritus, sedation, hypotension), and block-related complications (hematoma, local anesthetic systemic toxicity, infection).

Interventions

  • Procedure Thoracolumbar Interfascial Plane (TLIP) Block of bupivacaine
    Ultrasound-guided injection of 20 mL bilaterally (40 mL total) of 0.25% bupivacaine into the fascial plane between the multifidus and longissimus muscles at the relevant lumbar level, performed at the end of surgery before emergence from anesthesia, as part of routine postoperative analgesia.
  • Procedure Quadratus Lumborum-Iliac Plane (QIP) Block
    Ultrasound-guided injection of 20 mL bilaterally (40 mL total) of 0.25% bupivacaine into the interfascial plane between the erector spinae and quadratus lumborum muscles at the iliac crest level, performed at the end of surgery before emergence from anesthesia, as part of routine postoperative analgesia.

Primary outcome measures

  • Total Opioid Consumption in the First 24 Postoperative Hours [Time frame: 0 to 24 hours after surgery]
Secondary outcome measures (4)
  • Time to First Opioid Request [Time frame: Up to 24 hours after surgery]
  • Postoperative Pain Score (Visual Analog Scale) [Time frame: 0, 1, 2, 4, 8, 12, and 24 hours after surgery]
  • Incidence of Postoperative Side Effects [Time frame: Up to 24 hours after surgery]
  • Incidence of Block-Related Complications [Time frame: Up to 24 hours after surgery]

Eligibility criteria

Inclusion criteria

  • Aged 18-65 years
  • ASA physical status I-II
  • Undergoing elective lumbar discectomy at up to two spinal levels under general anesthesia
  • Receiving classic TLIP block or QIP block for postoperative analgesia as part of routine clinical practice

Exclusion criteria

  • Hypersensitivity or allergy to study medications
  • Coagulopathy
  • Infection at the injection site
  • Severe neurological deficit
  • Chronic opioid use
  • Advanced hepatic or renal failure
  • Obesity (BMI >35 kg/m2)
  • Pregnancy
  • ASA physical status III-IV
  • Mental retardation
  • Inability to provide informed consent

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Observational model
Cohort

Study locations

Turkey (Türkiye) · 1 center
  • Vezirköprü State Hospital — Vezirköprü

Publications

  • Tulgar S, Ciftci B, Ahiskalioglu A, Bilal B, Sakul BU, Girit M, Akin T, Narayanan M, Alici HA. Ultrasound guided quadro-iliac plane block: another novel fascial plane block. Pain Med. 2024 May 3;25(6):370-373. doi: 10.1093/pm/pnae018. PMID 38459608
  • Hand WR, Taylor JM, Harvey NR, Epperson TI, Gunselman RJ, Bolin ED, Whiteley J. Thoracolumbar interfascial plane (TLIP) block: a pilot study in volunteers. Can J Anaesth. 2015 Nov;62(11):1196-200. doi: 10.1007/s12630-015-0431-y. Epub 2015 Jul 7. PMID 26149600
  • Yeung J, Small C. Impact of regional analgesia in surgery. Br J Surg. 2021 Sep 27;108(9):1009-1010. doi: 10.1093/bjs/znab214. No abstract available. PMID 34131701
  • Andreae MH, Andreae DA. Regional anaesthesia to prevent chronic pain after surgery: a Cochrane systematic review and meta-analysis. Br J Anaesth. 2013 Nov;111(5):711-20. doi: 10.1093/bja/aet213. Epub 2013 Jun 28. PMID 23811426
  • Humble SR, Dalton AJ, Li L. A systematic review of therapeutic interventions to reduce acute and chronic post-surgical pain after amputation, thoracotomy or mastectomy. Eur J Pain. 2015 Apr;19(4):451-65. doi: 10.1002/ejp.567. Epub 2014 Aug 4. PMID 25088289
  • Dietz N, Sharma M, Adams S, Alhourani A, Ugiliweneza B, Wang D, Nuno M, Drazin D, Boakye M. Enhanced Recovery After Surgery (ERAS) for Spine Surgery: A Systematic Review. World Neurosurg. 2019 Oct;130:415-426. doi: 10.1016/j.wneu.2019.06.181. Epub 2019 Jul 2. PMID 31276851
  • Bajwa SJ, Haldar R. Pain management following spinal surgeries: An appraisal of the available options. J Craniovertebr Junction Spine. 2015 Jul-Sep;6(3):105-10. doi: 10.4103/0974-8237.161589. PMID 26288544

Identifiers

NCT: NCT07750418 · OMU KAEK 2026/248

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗