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NCT Number: NCT07448987

Ultrasound Guided Quadratus Lumborum Block, Thoracolumbar Interfascial Plane Block, and Local Anesthetic Infiltration for Lumbar Spine Fixation

This study aimed to compare the efficacy of ultrasound guided trans-muscular quadratus lumborum Block, thoracolumbar interfascial plane block and local anesthetic infiltration for elective lumbar spine fixation undergo up to three-level fixation.

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Key information

Conditions

Quadratus Lumborum Block Local Anesthetic Infiltration Lumbar Spine Fixation Thoracolumbar Interfascial Plane Block

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Tanta University

Tanta, El-Gharbia, 31527, Egypt

About this study

Back and leg pain arising from lumbar spine surgery is widespread, and its treatment can range from pharmacotherapy to surgical intervention. A majority of patients who undergo spinal surgery report experiencing moderate pain six months after the operation.

Interfascial plane blocks, including the thoracolumbar interfascial plane (TLIP) block target these posterior rami passing through the paraspinal muscles. Several studies have explored the analgesic efficacy of TLIP block in posterior lumbar spine surgery.

Quadratus lumborum block (QLB) is a posterior abdominal wall fascial block where local anesthetic is administered around QL muscle. play a significant role in contemporary medical practice for enhancing post-spinal surgery pain management.

Local infiltrative analgesia applied in layers of the surgical wound layers has been suggested as an appealing alternative due to its simplicity, enhanced safety, and limited cost, also a popular modality for postoperative analgesia in spine surgery.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age from 18 to 65 years.
  • Both genders.
  • American Society of Anesthesiology (ASA) class I - II.
  • Scheduled for elective lumbar spine fixation up to three level.

Exclusion criteria

  • Patient refusal.
  • History of allergy to local anesthetic.
  • Mental dysfunction or cognitive disorders.
  • Body Mass Index > 30 kg/m2.
  • Coagulopathy.
  • Pregnancy.
  • Infections to the site of the block.

Treatment and study plan

Quadratus lumborum block

Other

Patients received general anesthesia and bilateral ultrasound guided trans-muscular quadratus lumborum block (QLB 3) with (20 ml Bupivacaine 0.25% each side) + (Dexmedetomidine 0.5 mic/kg) for each side as total volume (1 mic/kg).

Thoracolumbar interfascial plane block

Other

Patients received general anesthesia and bilateral ultrasound guided thoracolumbar interfascial plane block with (20ml of Bupivacaine 0.25%) for each side + (Dexmedetomidine 0.5 mic/kg) for each side as total volume (1 mic/kg).

Local anesthetic infiltration

Other

Patients received general anesthesia and local anesthetic infiltration at the side of incision before with (40 ml of Bupivacaine 0.25%) + (Dexmedetomidine 1mic/kg).

Primary outcomes

  1. Total morphine consumption

    Time frame: 24 hours postoperatively

    Intravenous morphine (0.05mg/kg) was given when numeric rating scale (NRS) equal or above 4.

Secondary outcomes

  1. Mean arterial pressure

    Time frame: Till end of surgery (Up to 2 hours)

    Mean arterial pressure was recorded before induction of anesthesia (base-line value), after prone position, at the time of skin incision and after skin incision by 5,15 and 30 minutes, and at the end of the operation.

  2. Heart rate

    Time frame: Till end of surgery (Up to 2 hours)

    Heart rate was recorded before induction of anesthesia (base-line value), after prone position, at the time of skin incision and after skin incision by 5,15 and 30 minutes, and at the end of the operation.

  3. Time to the first request for rescue analgesia

    Time frame: 24 hours postoperatively

    Time to the first request for rescue analgesia was recorded from the end of surgery till first dose of morphine administrated.

  4. Degree of pain

    Time frame: 24 hours postoperatively

    Each patient was instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS were the 0th (PACU), 1th, 3rd, 6th, 12th, and 24th postoperative hours.

Sponsors and collaborators

Lead sponsor

Tanta University

Other

Registry information

Official study title

Comparison of The Efficacy of Ultrasound Guided Quadratus Lumborum Block, Thoracolumbar Interfascial Plane Block, and Local Anesthetic Infiltration for Lumbar Spine Fixation: Prospective Randomized Trial

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Mar 4, 2026
Registry last updated
Mar 4, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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