Comparison of Posterior QLB and QIPB in Pediatric Undescended Testis Surgery.

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

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.

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.