Postoperative Pain ManagementNCT07480278
mTLIP vs QIPB for Postoperative Analgesia in Lumbar Microdiscectomy Surgery
A study testing Modified Thoracolumbar Interfascial Plane Block (mTLIP) and Quadro-Iliac Plane Block (QIPB) in people with Postoperative Pain Management, run by Bursa City Hospital at 1 site in Turkey (Türkiye).
Trial summary
The aim of this prospective randomized clinical study is to compare the analgesic efficacy and side effects of modified thoracolumbar interfascial plane block and quadroiliac plane block applied preoperatively in patients undergoing lumbar microdiscectomy surgery.The study will include a total of 80 patients aged… Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Postoperative Pain Management
- What is being tested?
- Modified Thoracolumbar Interfascial Plane Block (mTLIP) and Quadro-Iliac Plane Block (QIPB)
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 80 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 25 Mar 2026to 1 Sep 2026
- 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 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age between 18 and 65 years
- Classified as American Society of Anesthesiologists physical status I-III
- Scheduled for elective lumbar microdiscectomy surgery under general anesthesia
- Provision of written informed consent
Who cannot join
- Use of anticoagulant medications or presence of bleeding diathesis
- Known allergy or hypersensitivity to local anesthetics or opioid drugs
- Infection at the planned block site
- Alcohol or drug dependence
- Cognitive impairment preventing reliable pain assessment
- Pregnancy or lactation
Show all 9Show fewer
- History of previous lumbar spine surgery
- Diabetes mellitus
- Renal or hepatic insufficiency
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site, 1 recruiting
- Recruiting
Bursa City Hospital
Bursa, Nilüfer, 16110
Merih Yildiz Eglen, MD, +905059340629, meriheg@yahoo.com
About this study
Official title: Comparison of Ultrasound-Guided Modified Thoracolumbar Interfascial Plane Block Versus Quadro-Iliac Plane Block for Postoperative Analgesia in Patients Undergoing Lumbar Microdiscectomy
The aim of this prospective randomized clinical study is to compare the analgesic efficacy and side effects of modified thoracolumbar interfascial plane block and quadroiliac plane block applied preoperatively in patients undergoing lumbar microdiscectomy surgery.The study will include a total of 80 patients aged 18-65 years with ASA I-III, with 40 patients in each group( Group mTLIP and Group QIPB) undergoing lumbar microdiscectomy surgery.
The primary objective of the study is to compare groups in terms of PCA opioid consumption during the 48-hour postoperative period. Secondary objectives are to compare groups in terms of QoR-15 recovery score, dynamic and static numerical rating scale scores, total rescue analgesic use, time to first request for rescue analgesia, length of hospital stay, block and opioid-related side effects and complications, and perioperative remifentanil infusion dose.
Read the detailed description
Lumbar spine surgery is commonly associated with moderate to severe postoperative pain . Inadequate pain control may lead to delayed mobilisation, increased cardiopulmonary complications, and prolonged hospital stay.
Ultrasound-guided regional analgesia techniques, particularly fascial plane blocks, are increasingly used as part of multimodal analgesia in lumbar spine surgery. The thoracolumbar interfascial plane (TLIP) block is an established technique that provides effective analgesia and has been modified to improve its clinical application, resulting in the modified thoracolumbar interfascial plane (mTLIP) block. Previous studies have demonstrated the effectiveness of mTLIP for postoperative analgesia after lumbar spine surgeries.
The quadro-iliac plane block (QIPB) is a recently described ultrasound-guided fascial plane block. Early reports suggest that QIPB may provide effective analgesia in lumbar spine procedures; however, comparative evidence with established techniques remains limited.
This prospective randomized clinical trial aims to compare bilateral ultrasound-guided mTLIP and QIPB performed before the surgery in patients undergoing elective lumbar microdiscectomy surgery under general anesthesia, to evaluate whether QIPB can be considered a safe and effective alternative to mTLIP for postoperative analgesia.
- Conditions
- Postoperative Pain Management
- Being tested
- Modified Thoracolumbar Interfascial Plane Block (mTLIP), Quadro-Iliac Plane Block (QIPB)
- Keywords
- Postoperative pain, Quadro-iliac plane block, Lumbar Microdiscectomy, Modified thoracolumbar interfascial plane block
- Medical subject headings
- Pain, Postoperative
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Modified Thoracolumbar Interfascial Plane Block (mTLIP)Procedure or surgery
This is a fascial plane block in which a local anesthetic is injected into the interfascial plane between the longissimus and iliocostalis muscles. Participants in this group will undergo bilateral modified thoracolumbar interfascial plane blocks (mTLIP) under ultrasound guidance prior to surgery. Under sterile conditions, with the patient in the prone position, the ultrasound probe will be placed in the parasagittal plane at the midpoint of the surgical incision, taking into account the lumbar levels to be operated on. The paraspinal muscles will be identified, and using an in-plane technique, the needle will be advanced into the interfascial plane between the longissimus and iliocostalis muscles. Correct needle placement will be confirmed with saline solution. A total of 40 mL of 0.25% bupivacaine and 5 µg/mL (1:200,000) adrenaline-containing local anesthetic solution (20 mL for each side) will be used for the block procedures.
Quadro-Iliac Plane Block (QIPB)Procedure or surgery
This is a fascial plane block is a procedure in which local anesthetic is injected at the point where the quadratus lumborum muscle attaches to the iliac crest, allowing it to spread between the erector spinae and quadratus lumborum muscles. Participants in the QIPB Group will undergo bilateral quadrioliac plane blocks (QIPB) under ultrasound guidance prior to surgery. Under sterile conditions, with the patient in the prone position, a convex ultrasound probe will be placed at the point where the quadratus lumborum muscle attaches to the iliac crest to identify the erector spinae and quadratus lumborum muscles. After confirming the needle placement with saline, a local anesthetic solution containing 0.25% bupivacaine and 5 µg/mL (1:200,000) adrenaline will be administered, total 40 mL (20 mL for each side). The spread of the local anesthetic solution between the erector spinae and quadratus lumborum muscles will be visualized
| Study group | Role | What they receive |
|---|---|---|
| Group mTLIP | Experimental | Patients in this group will undergo bilateral mTLIP block under ultrasound guidance prior to surgery. Receives: Procedure: Modified Thoracolumbar Interfascial Plane Block (mTLIP) |
| Group QIPB | Experimental | Patients in this group will undergo bilateral QIPB block under ultrasound guidance prior to surgery. Receives: Procedure: Quadro-Iliac Plane Block (QIPB) |
What is being measured
The primary outcome is the main question the study is designed to answer.
1. Postoperative 48-Hour PCA Opioid Consumption
Description: Total amount of opioid delivered by the patient-controlled analgesia (PCA) device during the first 48 hours after surgery, recorded in milligrams (mg).
Measured: Time Frame: Postoperative 0-8, 8-16, 16-24 24-48 hours intervals
Secondary outcomes (7)
QoR-15 Recovery Score
The investigators will use the Turkish version of Quality of Recovery (QoR) / QoR-15 questionairre PART A How have you been feeling in the last 24 hours? (0 to 10, where: 0 = none of the time [poor] and 10 = all of the time [excellent]) Able to breathe easily Been able to enjoy food Feeling rested Have had a good sleep Able to look after personal toilet and hygiene unaided Able to communicate with Getting support from hospital doctors and nurses Able to return to work or usual home activities Feeling comfortable and in control Having a feeling of general well-being PART B Have you had any of the following in the last 24 hours? (10 to 0, where: 10 = none of the time [excellent] and 0 = all of the time [poor]) Moderate pain Severe pain Nausea or vomiting Feeling worried or anxious Feeling sad or depressed
Measured: Postoperative 24th and 48th hours
Dynamic and static Numeric Rating Scale scores
Description: Numeric Rating Scale (NRS) (0-10; 0= no pain, 10 = the most severe pain felt) pain scores at rest or movement at predefined postoperative hours
Measured: 0, 2, 4, 8, 16, 24, and 48 hours postoperatively
Total rescue analgesic dose
Description: Despite the use of patient-controlled analgesia (PCA), if the Numeric Rating Scale (NRS) score is ≥4 at any time point, 0.5 mg/kg intravenous meperidine will be administered as rescue analgesia. Total amount of meperidin during the first 24 and 48 hours after surgery, recorded in milligrams (mg).
Measured: Time Frame: Postoperative 48 hours
Time of first request for rescue analgesia
Description: Despite the use of patient-controlled analgesia (PCA), if the Numeric Rating Scale (NRS) score is ≥4 at any time point, 0.5 mg/kg intravenous meperidine will be administered as rescue analgesia.
Measured: Time Frame: Postoperative 48 hours
Length of Hospital Stay
Description: Length of hospital stay will be defined as the number of days from the end of surgery to hospital discharge
Measured: the day of discharge from the hospital (assessed up to 10 days)
Block and Opioid-Related Adverse Effects and Complications
Description: Block- and opioid-related adverse effects and complications, including but not limited to local anesthetic toxicity, hematoma, infection, nerve injury, nausea, vomiting, pruritus, sedation, and respiratory depression, will be recorded
Measured: Time Frame: Postoperative 48 hours
Perioperative Remifentanil infusion dose
The amount of remifentanil administered in micrograms during general anesthesia
Measured: During surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Mar 2026
- Study start25 Mar 2026
- Primary completion25 Jul 2026 (estimated)
- Study completion1 Sep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Postoperative Pain ManagementStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Double blind
- Who is masked
- Care provider, Outcomes assessor
- Enrolment
- 80 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Bursa City Hospital
- Sponsor type
- Other government
- Responsible party
- Principal investigator, Merih Yıldız Eglen, Bursa City Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07480278
- Sponsor's protocol ID
- BursaCityHOS 5
- Status last verified
- Mar 2026
- First submitted
- 9 Mar 2026
- Last updated
- 27 Mar 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Turan EI, Aslan C, Berber K, Sarban O, Sahin AS. Efficacy of quadro-iliac plane block in single level lumbar discectomies: a case series for novel block. Minerva Anestesiol. 2024 Dec;90(12):1159-1160. doi: 10.23736/S0375-9393.24.18314-9. Epub 2024 Sep 11. No abstract available.
PubMed 39258831Ciftci B, Ekinci M. A prospective and randomized trial comparing modified and classical techniques of ultrasound-guided thoracolumbar interfascial plane block. Agri. 2020 Nov;32(4):186-192. doi: 10.14744/agri.2020.72325.
PubMed 33398870Turan EI, Sahin AS. Quadro-iliac plane block (QIPB) in lumbar stabilisation surgeries: A case series. Indian J Anaesth. 2025 Feb;69(2):244-245. doi: 10.4103/ija.ija_1077_24. Epub 2025 Jan 29. No abstract available.
PubMed 40160919Tulgar S, Ciftci B, Ahiskalioglu A, Bilal B, Sakul BU, Girit M, Akin T, Narayanan M, Alici HA. Ultrasound guided quadro-iliac plane block: another novel fascial plane block. Pain Med. 2024 May 3;25(6):370-373. doi: 10.1093/pm/pnae018.
PubMed 38459608Alver S, Ciftci B, Celik EC, Sargolzaeimoghaddam M, Cetinkal A, Erdogan C, Ahiskalioglu A. Postoperative recovery scores and pain management: a comparison of modified thoracolumbar interfascial plane block and quadratus lumborum block for lumbar disc herniation. Eur Spine J. 2024 Jan;33(1):118-125. doi: 10.1007/s00586-023-07812-3. Epub 2023 Jun 14.
PubMed 37314577
Study at a glance
From the registry record, last updated by the sponsor on 27 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of Ultrasound-Guided Modified Thoracolumbar Interfascial Plane Block Versus Quadro-Iliac Plane Block for Postoperative Analgesia in Patients Undergoing Lumbar Microdiscectomy
- ClinicalTrials.gov ID
- NCT07480278
- Acronym / sponsor ID
- BursaCityHOS 5
- Conditions
- Postoperative Pain Management
- Keywords
- Postoperative pain, Quadro-iliac plane block, Lumbar Microdiscectomy, Modified thoracolumbar interfascial plane block
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 80 participants (estimated)
- Lead sponsor
- Bursa City HospitalOther government
- Study start
- 25 Mar 2026 (actual)
- Primary completion
- 25 Jul 2026 (estimated)
- Study completion
- 1 Sep 2026 (estimated)
- First posted
- 18 Mar 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this prospective randomized clinical study is to compare the analgesic efficacy and side effects of modified thoracolumbar interfascial plane block and quadroiliac plane block applied preoperatively in patients undergoing lumbar microdiscectomy surgery.The study will include a total of 80 patients aged 18-65 years with ASA I-III, with 40 patients in each group( Group mTLIP and Group QIPB) undergoing lumbar microdiscectomy surgery.
The primary objective of the study is to compare groups in terms of PCA opioid consumption during the 48-hour postoperative period. Secondary objectives are to compare groups in terms of QoR-15 recovery score, dynamic and static numerical rating scale scores, total rescue analgesic use, time to first request for rescue analgesia, length of hospital stay, block and opioid-related side effects and complications, and perioperative remifentanil infusion dose.
Detailed description
Lumbar spine surgery is commonly associated with moderate to severe postoperative pain . Inadequate pain control may lead to delayed mobilisation, increased cardiopulmonary complications, and prolonged hospital stay.
Ultrasound-guided regional analgesia techniques, particularly fascial plane blocks, are increasingly used as part of multimodal analgesia in lumbar spine surgery. The thoracolumbar interfascial plane (TLIP) block is an established technique that provides effective analgesia and has been modified to improve its clinical application, resulting in the modified thoracolumbar interfascial plane (mTLIP) block. Previous studies have demonstrated the effectiveness of mTLIP for postoperative analgesia after lumbar spine surgeries.
The quadro-iliac plane block (QIPB) is a recently described ultrasound-guided fascial plane block. Early reports suggest that QIPB may provide effective analgesia in lumbar spine procedures; however, comparative evidence with established techniques remains limited.
This prospective randomized clinical trial aims to compare bilateral ultrasound-guided mTLIP and QIPB performed before the surgery in patients undergoing elective lumbar microdiscectomy surgery under general anesthesia, to evaluate whether QIPB can be considered a safe and effective alternative to mTLIP for postoperative analgesia.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (care provider, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group mTLIP | Experimental | Procedure: Modified Thoracolumbar Interfascial Plane Block (mTLIP)Patients in this group will undergo bilateral mTLIP block under ultrasound guidance prior to surgery. |
| Group QIPB | Experimental | Procedure: Quadro-Iliac Plane Block (QIPB)Patients in this group will undergo bilateral QIPB block under ultrasound guidance prior to surgery. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Age between 18 and 65 years
- Classified as American Society of Anesthesiologists physical status I-III
- Scheduled for elective lumbar microdiscectomy surgery under general anesthesia
- Provision of written informed consent
Key exclusion criteria (9 listed)
- Use of anticoagulant medications or presence of bleeding diathesis
- Known allergy or hypersensitivity to local anesthetics or opioid drugs
- Infection at the planned block site
- Alcohol or drug dependence
- Cognitive impairment preventing reliable pain assessment
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Modified Thoracolumbar Interfascial Plane Block (mTLIP)This is a fascial plane block in which a local anesthetic is injected into the interfascial plane between the longissimus and iliocostalis muscles. Participants in this group will undergo bilateral modified thoracolumbar interfascial plane blocks (mTLIP) under ultrasound guidance prior to surgery. Under sterile conditions, with the patient in the prone position, the ultrasound probe will be placed in the parasagittal plane at the midpoint of the surgical incision, taking into account the lumbar levels to be operated on. The paraspinal muscles will be identified, and using an in-plane technique, the needle will be advanced into the interfascial plane between the longissimus and iliocostalis muscles. Correct needle placement will be confirmed with saline solution. A total of 40 mL of 0.25% bupivacaine and 5 µg/mL (1:200,000) adrenaline-containing local anesthetic solution (20 mL for each side) will be used for the block procedures. | Procedure or surgery | Group mTLIP |
| Quadro-Iliac Plane Block (QIPB)This is a fascial plane block is a procedure in which local anesthetic is injected at the point where the quadratus lumborum muscle attaches to the iliac crest, allowing it to spread between the erector spinae and quadratus lumborum muscles. Participants in the QIPB Group will undergo bilateral quadrioliac plane blocks (QIPB) under ultrasound guidance prior to surgery. Under sterile conditions, with the patient in the prone position, a convex ultrasound probe will be placed at the point where the quadratus lumborum muscle attaches to the iliac crest to identify the erector spinae and quadratus lumborum muscles. After confirming the needle placement with saline, a local anesthetic solution containing 0.25% bupivacaine and 5 µg/mL (1:200,000) adrenaline will be administered, total 40 mL (20 mL for each side). The spread of the local anesthetic solution between the erector spinae and quadratus lumborum muscles will be visualized | Procedure or surgery | Group QIPB |
Primary outcome
1. Postoperative 48-Hour PCA Opioid Consumption
Time frame: Time Frame: Postoperative 0-8, 8-16, 16-24 24-48 hours intervals
Description: Total amount of opioid delivered by the patient-controlled analgesia (PCA) device during the first 48 hours after surgery, recorded in milligrams (mg).
7 secondary outcomes
QoR-15 Recovery Score
Time frame: Postoperative 24th and 48th hours
Dynamic and static Numeric Rating Scale scores
Time frame: 0, 2, 4, 8, 16, 24, and 48 hours postoperatively
Total rescue analgesic dose
Time frame: Time Frame: Postoperative 48 hours
Time of first request for rescue analgesia
Time frame: Time Frame: Postoperative 48 hours
Length of Hospital Stay
Time frame: the day of discharge from the hospital (assessed up to 10 days)
Block and Opioid-Related Adverse Effects and Complications
Time frame: Time Frame: Postoperative 48 hours
Perioperative Remifentanil infusion dose
Time frame: During surgery
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Mar 2026.
- Background: PubMed 39258831Turan EI, Aslan C, Berber K, Sarban O, Sahin AS. Efficacy of quadro-iliac plane block in single level lumbar discectomies: a case series for novel block. Minerva Anestesiol. 2024 Dec;90(12):1159-1160. doi: 10.23736/S0375-9393.24.18314-9. Epub 2024 Sep 11. No abstract available.
- Background: PubMed 33398870Ciftci B, Ekinci M. A prospective and randomized trial comparing modified and classical techniques of ultrasound-guided thoracolumbar interfascial plane block. Agri. 2020 Nov;32(4):186-192. doi: 10.14744/agri.2020.72325.
- Background: PubMed 40160919Turan EI, Sahin AS. Quadro-iliac plane block (QIPB) in lumbar stabilisation surgeries: A case series. Indian J Anaesth. 2025 Feb;69(2):244-245. doi: 10.4103/ija.ija_1077_24. Epub 2025 Jan 29. No abstract available.
- Background: PubMed 38459608Tulgar S, Ciftci B, Ahiskalioglu A, Bilal B, Sakul BU, Girit M, Akin T, Narayanan M, Alici HA. Ultrasound guided quadro-iliac plane block: another novel fascial plane block. Pain Med. 2024 May 3;25(6):370-373. doi: 10.1093/pm/pnae018.
- Background: PubMed 37314577Alver S, Ciftci B, Celik EC, Sargolzaeimoghaddam M, Cetinkal A, Erdogan C, Ahiskalioglu A. Postoperative recovery scores and pain management: a comparison of modified thoracolumbar interfascial plane block and quadratus lumborum block for lumbar disc herniation. Eur Spine J. 2024 Jan;33(1):118-125. doi: 10.1007/s00586-023-07812-3. Epub 2023 Jun 14.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Modified Thoracolumbar Interfascial Plane Block (mTLIP) and Quadro-Iliac Plane Block (QIPB) in people with Postoperative Pain Management, run by Bursa City Hospital at 1 site in Turkey (Türkiye).
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 4 inclusion and 9 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: looking for participants now, as of the sponsor's last update on 27 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
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?
Contact Merih Yildiz Eglen, MD (+905059340629, meriheg@yahoo.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
1. Postoperative 48-Hour PCA Opioid Consumption (time frame: Time Frame: Postoperative 0-8, 8-16, 16-24 24-48 hours intervals). 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 NCT07480278, which also lists 5 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 27 Mar 2026.