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Kidney DiseasesESP-QLB-PedsNCT07346417

Erector Spinae Plane Block Versus Quadratus Lumborum Block

A study testing Quadratus lumborum block teqnique and Erector spinae plane block Technique in people with Kidney Diseases, run by Assiut University.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Official record
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Trial summary

To compare the efficacy and safety of ultrasound-guided ESPB versus QLB for post-operative analgesia in children undergoing kidney surgery. Read more about this study

Who is it for?
Ages 2 to 12 years
Conditions the study is for
Kidney Diseases
What is being tested?
Quadratus lumborum block teqnique and Erector spinae plane block Technique
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
No sites listed yet
Study dates
25 Dec 2025to 30 Mar 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 2 to 12 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Children of both sexes, aged 2-12 years, with ASA physical status I-II scheduled for elective unilateral kidney surgery will be eligible.

Who cannot join

  • Infection at the site of needle insertion
  • Allergy to local anesthetics
  • Parental refusal of consent

About this study

Official title: Erector Spinae Plane Block Versus Quadratus Lumborum Block for Post Operative Analgesia in Pediatric Kidney Surgery

To compare the efficacy and safety of ultrasound-guided ESPB versus QLB for post-operative analgesia in children undergoing kidney surgery.

Read the detailed description

The management of postoperative pain in pediatric kidney surgery is a critical component of enhanced recovery and improved patient outcomes. Effective analgesia minimizes opioid consumption and their associated side effects, facilitating early mobilization and discharge. Regional anesthesia techniques have gained prominence as opioid-sparing modalities in pediatric patients, with the erector spinae plane block (ESPB) and quadratus lumborum block (QLB) increasingly used in abdominal and renal surgeries.

The erector spinae plane block is a fascial plane block targeting the dorsal rami of spinal nerves, providing extensive analgesia for thoracic and abdominal procedures. It is considered relatively easy and safe to perform under ultrasound guidance and has been associated with effective postoperative analgesia and reduced opioid requirements in pediatric renal surgery. Additional advantages include shorter block performance time and a lower incidence of postoperative nausea and vomiting compared with other regional techniques.

The quadratus lumborum block involves local anesthetic deposition near the quadratus lumborum muscle and can be performed using different approaches, such as anterior and transmuscular techniques. These approaches provide both somatic and visceral analgesia for lower abdominal and renal surgeries. Continuous quadratus lumborum block has demonstrated effective postoperative pain control, reduced need for rescue analgesia, and minimal adverse events in pediatric renal procedures. It is also recognized for its favorable safety profile and its contribution to improved quality of recovery.

Although both ESPB and QLB are effective regional techniques for pediatric postoperative analgesia, studies comparing their efficacy have reported variable results. Some investigations have shown comparable pain scores and opioid consumption between the two blocks, while others suggest potential advantages of one technique over the other in terms of analgesic duration, side-effect profile, or patient satisfaction.

Pain assessment in pediatric patients remains challenging because of differences in age, cognitive development, and communication abilities. This necessitates the use of objective pain scoring systems and careful perioperative analgesic planning. Consequently, evaluating and comparing the analgesic efficacy and safety of these two regional blocks in pediatric kidney surgery is of particular clinical importance.

The rationale of this study is to provide direct comparative evidence on the effectiveness and safety of ultrasound-guided ESPB versus QLB for postoperative analgesia in pediatric kidney surgery. Clarifying which technique offers superior analgesic control with fewer side effects may help optimize perioperative pain management protocols and improve postoperative outcomes. This study aims to assess postoperative pain scores, opioid consumption, block-related complications, and recovery quality in order to guide anesthetic decision-making in pediatric renal surgery

Conditions
Kidney Diseases
Being tested
Quadratus lumborum block teqnique, Erector spinae plane block Technique
Keywords
Pediatric- kidney-surgery
Medical subject headings
Kidney Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Quadratus lumborum block teqniqueProcedure or surgery

    All blocks were performed under ultrasound guidance. A high-frequency linear probe was positioned in the mid-axillary line cranial to the iliac crest to identify the abdominal wall muscles (external oblique, internal oblique, and transversus abdominis). The probe was then moved dorsally until the transversus abdominis muscle became aponeurotic, which was followed medially to visualize the quadratus lumborum (QL) muscle at its attachment to the L4 transverse process adjacent to the psoas muscle.

    Using an in-plane anterior-to-posterior approach, the block needle was advanced toward the anterior border of the QL muscle. After confirming the needle tip position with a 1 ml saline test injection, 0.5 ml/kg of 0.25% bupivacaine was administered. Bilateral injections were performed for midline incisions, while unilateral injections were used for paramedian incisions.

  • Erector spinae plane block TechniqueProcedure or surgery

    Ultrasound-guided erector spinae plane block performed at the thoracic level using a single-shot technique in pediatric patients undergoing kidney surgery to provide postoperative analgesia. Local anesthetic is injected deep to the erector spinae muscle over the transverse process with expected craniocaudal spread.

Study groups in NCT07346417
Study groupRoleWhat they receive
Erector spinae plane blockExperimentalUltrasound-guided erector spinae plane block performed at the thoracic level using a multi-shot technique after completion of surgery and before extubation for pediatric kidney surgery to provide postoperative analgesia.
Receives: Procedure: Quadratus lumborum block teqnique; Procedure: Erector spinae plane block Technique
Quadratus lumborum blockActive comparatorUltrasound-guided quadratus lumborum block performed using a multi-shot technique, after completion of surgery and before extubation of anesthesia for pediatric kidney surgery to provide postoperative analgesia.
Receives: Procedure: Quadratus lumborum block teqnique; Procedure: Erector spinae plane block Technique

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Time to first rescue analgesia

    measured from extubation until the first request/administration of analgesia, in hours

    Measured: 24 hours

Secondary outcomes (6)
  1. Total analgesic consumption

    Total 24-hour postoperative analgesic consumption (mg/kg paracetamol, µg/kg fentanyl).

    Measured: 24 hours

  2. Postoperative pain score

    FLACC pain score assessed at 0, 1, 2, 6, 12, and 24 hours postoperatively.

    Measured: 24 hours

  3. Incidence of postoperative nausea and vomiting

    Incidence of PONV within 24 hours postoperatively.

    Measured: 24 hours

  4. Block-related complications

    Incidence of block-related complications.

    Measured: 24 hours

  5. Postoperative hemodynamic stability

    Changes in heart rate and blood pressure >20% from baseline.

    Measured: 24 hours

  6. Parent satisfaction

    Parent satisfaction measured using a 5-point Likert scale.

    Measured: 24 hours

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Jan 2026
  2. Study start25 Dec 2025 (estimated)
  3. Primary completion28 Feb 2028 (estimated)
  4. Study completion30 Mar 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07346417
Sponsor's protocol ID
Pediatric-Block-Study-2025
Acronym
ESP-QLB-Peds
Status last verified
Jan 2026
First submitted
25 Dec 2025
Last updated
16 Jan 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Wu X, He H, Zhao L, Zeng Z, Yuan J. Case Report: Gastric cancer with chondromyxoid matrix similar matrix-producing metaplastic breast carcinoma: report of an undescribed entity. Front Oncol. 2023 May 19;13:1087241. doi: 10.3389/fonc.2023.1087241. eCollection 2023.

    PubMed 37274268
  • Sac G, Ozulug M, Geiger MF, Freyhof J. Pseudophoxinus cilicicus, a new spring minnow from southern Anatolia (Teleostei: Leuciscidae). Zootaxa. 2019 Sep 16;4671(1):zootaxa.4671.1.8. doi: 10.11646/zootaxa.4671.1.8.

    PubMed 31716597
  • Aksu C, Gurkan Y. Ultrasound guided erector spinae block for postoperative analgesia in pediatric nephrectomy surgeries. J Clin Anesth. 2018 Mar;45:35-36. doi: 10.1016/j.jclinane.2017.12.021. Epub 2017 Dec 20. No abstract available.

    PubMed 29274546
  • Wu L, Zhang W, Wei Y, Zhang D. Comparison of the analgesic effects of ultrasound-guided erector spinae plane block and quadratus lumborum block: a systematic review and meta-analysis. Front Pharmacol. 2025 Aug 1;16:1640135. doi: 10.3389/fphar.2025.1640135. eCollection 2025.

    PubMed 40822461
  • Aksoy M, Aksoy AN, Yilmaz EPT, Senocak GNC, Dostbil A, Ozkan H. The effectiveness of erector spina plane, quadratus lumborum blocks, and intrathecal morphine for analgesia after cesarean: a randomized study. Rev Assoc Med Bras (1992). 2023 Nov 13;69(12):e20230867. doi: 10.1590/1806-9282.20230867. eCollection 2023.

    PubMed 37971133
  • Zhang M, Zhao S, Song S, Zhou H, Li M, Su P, Xu G. Comparative analgesic efficacy of erector spinae plane block versus quadratus lumborum block in laparoscopic renal cancer surgery: a double-blind randomized trial. Transl Androl Urol. 2025 Jul 30;14(7):2029-2042. doi: 10.21037/tau-2025-71. Epub 2025 Jul 28.

    PubMed 40800097
  • An Y, Li L, Li Z, Lan F, Wang T, Ou T, Liang C, Wang P, Jia X, Song H, Cui K, Luo H, Zhao L. Anterior quadratus lumborum block is superior to erector spinae plane block for analgesia after renal transplantation: a randomized controlled trial. BMC Anesthesiol. 2025 Jul 10;25(1):343. doi: 10.1186/s12871-025-03209-5.

    PubMed 40640721
  • Wu H, Huang J. Quadratus lumborum block versus caudal block in paediatric surgeries: a protocol for systematic review and meta-analysis. BMJ Open. 2025 May 28;15(5):e100085. doi: 10.1136/bmjopen-2025-100085.

    PubMed 40441771
  • Kayumova PM, Giyasov SI, Krasnenkova MB, Musabaev AN. Erector Spinae Plane block: evaluation of its efficacy as a component of multimodal anaesthesia in open kidney surgery. Urology Herald. 2024;12(1):36-44.

  • Kambey BI, Ramlan AAW, Rahendra R, Selene NB. Ultrasonogram-Guided Continuous Quadratus Lumborum Block as Pain Management in Pediatric Kidney Transplant Recipients: A Case Series. Exp Clin Transplant. 2025 Jan;23(1):72-77. doi: 10.6002/ect.2024.0205.

    PubMed 39918196
  • Capuano P, Burgio G, Abbate S, Ranucci G, Bici K, Cintorino D, Arcadipane A, Martucci G. Continuous Erector Spinae Plane Block for Pain Management in a Pediatric Kidney Transplant Recipient: A Case Report and Review of the Current Literature. J Clin Med. 2024 Feb 17;13(4):1128. doi: 10.3390/jcm13041128.

    PubMed 38398441

Questions about this trial

What is this clinical trial studying?

A study testing Quadratus lumborum block teqnique and Erector spinae plane block Technique in people with Kidney Diseases, run by Assiut University.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 16 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time to first rescue analgesia (time frame: 24 hours). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07346417, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Jan 2026.

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