Comparison of the Effects of Posterior Quadratus Lumborum Block and Quadroiliac Plane Block on Analgesic Consumption in Postoperative Pain Management in Pediatric Patients Undergoing Undescended Testis Surgery
Overview
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- Medipol University
- Enrollment
- 70
- Locations
- 1
- Primary Endpoint
- Postoperative Pain Score (FLACC) at 12 Hours
Overview
Brief Summary
This randomized, double-blind study compares the postoperative analgesic efficacy of ultrasound-guided Posterior Quadratus Lumborum Block (QLB) versus Quadroiliac Plane Block (QIPB) in pediatric patients aged 1-7 years undergoing unilateral undescended testis surgery.
Detailed Description
Lower abdominal surgeries, such as undescended testis repair (orchiopexy), are common in pediatric patients and can cause significant postoperative pain. While Posterior Quadratus Lumborum Block (QLB) is a known technique for somatic and visceral analgesia, the Quadroiliac Plane Block (QIPB) is a newer approach targeting the fascial plane posterior to the iliac bone.
In this prospective, randomized, controlled trial, 70 pediatric patients (ASA I-II, aged 1-7 years) will be randomly assigned to receive either a Posterior QLB or a QIPB under general anesthesia. Both blocks will be performed using ultrasound guidance with 0.5 mL/kg of 0.25% bupivacaine.
The study aims to evaluate and compare the analgesic efficacy of these two techniques. Postoperative pain will be assessed using the FLACC scale. Secondary objectives include comparing the time to first rescue analgesic, total analgesic consumption, and incidence of complications.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Supportive Care
- Masking
- Triple (Participant, Care Provider, Outcomes Assessor)
Eligibility Criteria
- Ages
- 1 Year to 7 Years (Child)
- Sex
- Male
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Male pediatric patients aged 1-7 years.
- •ASA physical status I or II.
- •Scheduled for unilateral undescended testis surgery.
- •Written informed consent obtained.
Exclusion Criteria
- •History of neurological deficit or developmental delay.
- •Bleeding diathesis or known coagulopathy.
- •History of allergy to local anesthetics.
- •Infection or skin lesion at the block injection site.
- •Congenital spinal anomaly.
- •Mental retardation or psychiatric history.
- •Liver or kidney dysfunction.
Arms & Interventions
Posterior QLB Group
Patients will be placed in the lateral decubitus position. Under ultrasound guidance, the probe will be placed at the posterior axillary line. The needle will be advanced to the posterior fascial plane of the quadratus lumborum muscle. A total of 0.5 mL/kg of 0.25% Bupivacaine will be injected
Intervention: Ultrasound-guided Posterior Quadratus Lumborum Block. (Procedure)
QIPB Group
Patients will be placed in the lateral decubitus position. Under ultrasound guidance, the probe will be placed at the level of the iliac crest. The needle will be targeted to the plane where the quadratus lumborum muscle attaches to the iliac bone. A total of 0.5 mL/kg of 0.25% Bupivacaine will be injected.
Intervention: Ultrasound-guided Quadroiliac Plane Block (Procedure)
Outcomes
Primary Outcomes
Postoperative Pain Score (FLACC) at 12 Hours
Time Frame: 12 hours post-surgery.
Pain severity assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) scale. The total score ranges from 0 to 10, where higher scores indicate worse pain.
Secondary Outcomes
- Time to First Rescue Analgesic Request.(Up to 24 hours.)
- Total Postoperative Analgesic Consumption(24 hours post-surgery.)
- Incidence of Postoperative Complications.(Up to 24 hours.)
- Postoperative Pain Scores (FLACC) at Other Time Points.(30 minutes, 1, 2, 4, 6, and 24 hours post-surgery.)
Investigators
Burak Omur
assistant professor
Medipol University