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| Name | Class |
|---|---|
| Biruni University | OTHER |
| Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization | OTHER |
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Posterior QLB Group | Experimental | 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 |
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| QIPB Group | Experimental | 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. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ultrasound-guided Posterior Quadratus Lumborum Block. | Procedure | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative 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. | 12 hours post-surgery. |
| Measure | Description | Time Frame |
|---|---|---|
| Time to First Rescue Analgesic Request. | Time in minutes from surgery completion to the first dose of rescue analgesia. | Up to 24 hours. |
| Total Postoperative Analgesic Consumption | Cumulative amount of rescue analgesics consumed (mg). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Burak Ömür | Contact | +905056215056 | bomur@medipol.edu.tr |
| Name | Affiliation | Role |
|---|---|---|
| Selçuk Alver | Biruni University | Study Chair |
| Volkan Özen | Prof. Dr. Cemil Tascioglu City Hospital, Istanbul. | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istanbul Medipol University | Recruiting | Istanbul | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| D003456 | Cryptorchidism |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| Ultrasound-guided Quadroiliac Plane Block | Procedure | 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 |
|
| 24 hours post-surgery. |
| Incidence of Postoperative Complications. | Assessment of complications such as urinary retention, motor block, hematoma, or ecchymosis at the injection site. | 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. | 30 minutes, 1, 2, 4, 6, and 24 hours post-surgery. |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013733 | Testicular Diseases |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D014564 | Urogenital Abnormalities |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D006058 | Gonadal Disorders |
| D004700 | Endocrine System Diseases |