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
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Total Opioid Consumption in the First 24 Postoperative Hours
研究概览
简要总结
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.
详细描述
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).
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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
排除标准
- •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
研究组 & 干预措施
TLIP Block
Patients who receive a classic thoracolumbar interfascial plane (TLIP) block for postoperative analgesia after lumbar discectomy, as determined by the treating anesthesiologist's routine clinical practice. The block is performed under ultrasound guidance in the fascial plane between the multifidus and longissimus muscles, using bilateral injections of 20 mL (40 mL total) of 0.25% bupivacaine
干预措施: Thoracolumbar Interfascial Plane (TLIP) Block of bupivacaine (Procedure)
QIP Block
Patients who receive a quadratus lumborum-iliac plane (QIP) block for postoperative analgesia after lumbar discectomy, as determined by the treating anesthesiologist's routine clinical practice. The block is performed under ultrasound guidance in the interfascial plane between the erector spinae and quadratus lumborum muscles at the iliac crest level, using bilateral injections of 20 mL (40 mL total) of 0.25% bupivacaine.
干预措施: Quadratus Lumborum-Iliac Plane (QIP) Block (Procedure)
结局指标
主要结局
Total Opioid Consumption in the First 24 Postoperative Hours
时间窗: 0 to 24 hours after surgery
Cumulative amount of intravenous tramadol (mg) administered as rescue analgesia during the first 24 hours after surgery in each group.
次要结局
- Time to First Opioid Request(Up to 24 hours after surgery)
- Postoperative Pain Score (Visual Analog Scale)(0, 1, 2, 4, 8, 12, and 24 hours after surgery)
- Incidence of Postoperative Side Effects(Up to 24 hours after surgery)
- Incidence of Block-Related Complications(Up to 24 hours after surgery)