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.
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 Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
TRIPLE
Enrollment
70
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.
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
Istanbul Medipol University
Istanbul, Turkey (Türkiye)
RECRUITINGPostoperative Pain Score (FLACC) at 12 Hours
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.
Time frame: 12 hours post-surgery.
Time to First Rescue Analgesic Request.
Time in minutes from surgery completion to the first dose of rescue analgesia.
Time frame: Up to 24 hours.
Total Postoperative Analgesic Consumption
Cumulative amount of rescue analgesics consumed (mg).
Time frame: 24 hours post-surgery.
Incidence of Postoperative Complications.
Assessment of complications such as urinary retention, motor block, hematoma, or ecchymosis at the injection site.
Time frame: Up to 24 hours.
Postoperative Pain Scores (FLACC) at Other Time Points.
Pain severity assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) scale at 30 minutes, 1, 2, 4, 6, and 24 hours. The total score ranges from 0 to 10, where higher scores indicate worse pain.
Time frame: 30 minutes, 1, 2, 4, 6, and 24 hours post-surgery.
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