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The investigators aimed to compare the effects of ultrasound guided erector spina plan block and posterior quadratus lumborum block on intraoperative and postoperative opioid consumption in patients who will undergo short segment lumbar stabilization surgery.
All participants will be monitored with ECG, SpO2, non-invasive blood pressure. In induction, 1mg/kg 2% lidocaine, 2-3mg/kg propofol, 1mcg/kg fentanyl, 2mg midazolam, 0.6 mg/kg rocuronium will be used. Anesthesia depth will be monitored with BIS (bispectral index), and anesthesia will be maintained with 50% oxygen-air mixture and sevoflurane. After patient intubation, invasive artery cannulation will be performed on the non-dominant hand, and the patients will be placed in a prone position. 20 cc bupivacaine of 0.25% will be administered to both regions bilaterally, by following the rules of asepsis, with a 10 cm pajunk needle accompanied by USG, the needle site will be confirmed with 3 mm saline.
BIS will be kept in the range of 40-50 throughout the case, and invasive arterial monitoring will be performed. 1 g paracetamol, 1 mg/kg tramadol and 4 mg ondansetron will be administered to the patients 30 minutes before the end of the surgery.
After appropriate extubation and wakefulness, patients will be transferred to the postoperative anesthesia care unit (PACU), where they will be followed for 24 hours.
An intravenous (IV) patient-controlled analgesia device (PCA) containing 100ml of tramadol at a concentration of 4mg/cc will be inserted. No infusion will be given, and the bolus dose will be set to 20mg, with a lock time of 20 minutes. In the postoperative period, 50 mg of dexketoprofen will be administered every 8 hours.
VAS values, vital signs, and possible opioid side effects of the patients at 0, 1, 2, 6, 12 and 24 hours will be recorded. After completing 24 hours, the patient will be separated from the IV PCA device and transferred to the service.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Erector Spina Plan Block Group (Group E) | Patients who underwent erector spina plane block before initiation of surgery after induction of anesthesia |
| |
| Posterior Quadratus Lumborum Block Group ( Group Q) | Patients who underwent posterior quadratus lumborum block block before initiation of surgery after induction of anesthesia |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Peripheral nerve block | Procedure | Ultrasound guided peripheral nerve block |
|
| Measure | Description | Time Frame |
|---|---|---|
| İntraoperative remifentanil consumption | The investigators aimed to compare intraoperative remifentanil consumption of two groups | At the end of the intraoperative period |
| Postoperative tramadol consumption | The investigators aimed to compare postoperative tramadol consumption of two groups | The investigators will record at postoperative 0. hour |
| Postoperative tramadol consumption | The investigators aimed to compare postoperative tramadol consumption of two groups | The investigators will record at postoperative 1. hour |
| Postoperative tramadol consumption | The investigators aimed to compare postoperative tramadol consumption of two groups | The investigators will record at postoperative 2. hour |
| Postoperative tramadol consumption | The investigators aimed to compare postoperative tramadol consumption of two groups | The investigators will record at postoperative 6. hour |
| Postoperative tramadol consumption | The investigators aimed to compare postoperative tramadol consumption of two groups | The investigators will record at postoperative 12. hour |
| Postoperative tramadol consumption | The investigators aimed to compare postoperative tramadol consumption of two groups |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative nausea and vomiting | Whether there is postoperative nausea and vomiting will be questioned by the investigators. Yes or no will be marked in the table. | The investigators will record within 24 hours postoperatively. |
| Postoperative pruritus |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative pulse rate | The investigators aimed to compare patient's pulse rates of two groups. | The investigators will record at postoperative 0. hour |
| Postoperative pulse rate | The investigators aimed to compare patient's pulse rates of two groups. |
Inclusion Criteria:
Exclusion Criteria:
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Patients who will undergo lumbar stabilization operation under general anesthesia in Ankara Bilkent City Hospital Operating Room, between the ages of 18-65, both genders, and in the ASA I-III risk group will be included in the study.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara City Hospital, Bilkent | Ankara | Cankaya | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32669870 | Background | Qiu Y, Zhang TJ, Hua Z. Erector Spinae Plane Block for Lumbar Spinal Surgery: A Systematic Review. J Pain Res. 2020 Jul 1;13:1611-1619. doi: 10.2147/JPR.S256205. eCollection 2020. | |
| 30725897 | Background | Dhanjal ST, Tonder S. Quadratus Lumborum Block. 2023 Aug 14. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK537212/ |
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| The investigators will record at postoperative 24. hour |
Whether there is postoperative pruritus will be questioned by the investigators. Yes or no will be marked in the table. |
| The investigators will record within 24 hours postoperatively. |
| Postoperative visual analog scale | The investigators aimed to compare patient's visual analog scales of two groups. The visual pain scale is measured with a ruler from 0 to 10 cm. 0 indicates no pain, 10 indicates severe pain. | The investigators will record at postoperative 0. hour |
| Postoperative visual analog scale | The investigators aimed to compare patient's visual analog scales of two groups. The visual pain scale is measured with a ruler from 0 to 10 cm. 0 indicates no pain, 10 indicates severe pain. | We will record at postoperative 1. hour |
| Postoperative visual analog scale | The investigators aimed to compare patient's visual analog scales of two groups. The visual pain scale is measured with a ruler from 0 to 10 cm. 0 indicates no pain, 10 indicates severe pain. | The investigators will record at postoperative 2. hour |
| Postoperative visual analog scale | The investigators aimed to compare patient's visual analog scales of two groups. The visual pain scale is measured with a ruler from 0 to 10 cm. 0 indicates no pain, 10 indicates severe pain. | The investigators will record at postoperative 6. hour |
| Postoperative visual analog scale | The investigators aimed to compare patient's visual analog scales of two groups. The visual pain scale is measured with a ruler from 0 to 10 cm. 0 indicates no pain, 10 indicates severe pain. | The investigators will record at postoperative 12. hour |
| Postoperative visual analog scale | The investigators aimed to compare patient's visual analog scales of two groups. The visual pain scale is measured with a ruler from 0 to 10 cm. 0 indicates no pain, 10 indicates severe pain. | The investigators will record at postoperative 24. hour |
| The investigators will record at postoperative 1. hour |
| Postoperative pulse rate | The investigators aimed to compare patient's pulse rates of two groups. | The investigators will record at postoperative 2. hour |
| Postoperative pulse rate | The investigators aimed to compare patient's pulse rates of two groups. | The investigators will record at postoperative 6. hour |
| Postoperative pulse rate | The investigators aimed to compare patient's pulse rates of two groups. | The investigators will record at postoperative 12. hour |
| Postoperative pulse rate | The investigators aimed to compare patient's pulse rates of two groups. | The investigators will record at postoperative 24. hour |
| Postoperative oxygen saturation | The investigators aimed to compare patient's intraoperative oxygen saturations of two groups | The investigators will record at postoperative 0. hour |
| Postoperative oxygen saturation | The investigators aimed to compare patient's intraoperative oxygen saturations of two groups | The investigators will record at postoperative 1. hour |
| Postoperative oxygen saturation | The investigators aimed to compare patient's intraoperative oxygen saturations of two groups | The investigators will record at postoperative 2. hour |
| Postoperative oxygen saturation | The investigators aimed to compare patient's intraoperative oxygen saturations of two groups | The investigators will record at postoperative 6. hour |
| Postoperative oxygen saturation | The investigators aimed to compare patient's intraoperative oxygen saturations of two groups | The investigators will record at postoperative 12. hour |
| Postoperative oxygen saturation | The investigators aimed to compare patient's intraoperative oxygen saturations of two groups | The investigators will record at postoperative 24. hour |
| Postoperative sistolic and diastolic blood pressure | The investigators aimed to compare patient's blood pressures of two groups | The investigators will record at postoperative 0. hour |
| Postoperative sistolic and diastolic blood pressure | The investigators aimed to compare patient's blood pressures of two groups | The investigators will record at postoperative 1. hour |
| Postoperative sistolic and diastolic blood pressure | The investigators aimed to compare patient's blood pressures of two groups | The investigators will record at postoperative 2. hour |
| Postoperative sistolic and diastolic blood pressure | The investigators aimed to compare patient's blood pressures of two groups | The investigators will record at postoperative 6. hour |
| Postoperative sistolic and diastolic blood pressure | The investigators aimed to compare patient's blood pressures of two groups | The investigators will record at postoperative 12. hour |
| Postoperative sistolic and diastolic blood pressure | The investigators aimed to compare patient's blood pressures of two groups. | The investigators will record at postoperative 24. hour |
| Change from baseline systolic and diastolic blood pressure | The investigators aimed to compare patient's blood pressures change of two groups | The investigators will record every 10 minutes until the end of the surgery |
| Change from baseline pulse rate | The investigators aimed to compare patient's intraoperative pulse rates change of two groups | The investigators will record every 10 minutes until the end of the surgery |
| Change from baseline oxygen saturation | The investigators aimed to compare patient's baseline oxygen saturation change of two groups | The investigators will record every 10 minutes until the end of the surgery |
| 30688787 | Background | Elsharkawy H, El-Boghdadly K, Barrington M. Quadratus Lumborum Block: Anatomical Concepts, Mechanisms, and Techniques. Anesthesiology. 2019 Feb;130(2):322-335. doi: 10.1097/ALN.0000000000002524. No abstract available. |
| 34924770 | Background | Kang R, Lee S, Kim GS, Jeong JS, Gwak MS, Kim JM, Choi GS, Cho YJ, Ko JS. Comparison of Analgesic Efficacy of Erector Spinae Plane Block and Posterior Quadratus Lumborum Block in Laparoscopic Liver Resection: A Randomized Controlled Trial. J Pain Res. 2021 Dec 11;14:3791-3800. doi: 10.2147/JPR.S343366. eCollection 2021. |