Post Operative AnalgesiaNCT07480499
Erector Spinae Plane Versus Quadratus Lumborum Blocks for Pain Management After Total Abdominal Hysterectomy
A study testing Erector Spinae Plane Block and Quadratus Lumborum Block (QLB) in people with Post Operative Analgesia, run by Sheikh Khalifa Bin Zayed Al Nahyan Combined Military Hospital Muzaffarabad at 1 site in Pakistan.
Trial summary
TAH, being a large scale gynaecological operation, is a construction bound to cause serious postoperative pain to the patient in that the procedure will inevitably entail massive tissue dissection. Read more about this study
- Who is it for?
- Ages 35 to 65 years, women only
- Conditions the study is for
- Post Operative Analgesia
- What is being tested?
- Erector Spinae Plane Block and Quadratus Lumborum Block (QLB)
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 sitePakistan
- Study dates
- 1 Apr 2026to 30 Nov 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 35 to 65 years
- Women only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients aged 35-60 years. ASA physical status I or II. Elective Total Abdominal Hysterectomy under General Anesthesia.
Who cannot join
- Allergy with local anesthetics. Infection in the injection site. Coagulopathy or anticoagulant use. Morbid obesity (BMI > 35 kg/m²).
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site
SKBZN CMH Muzaffarabad
Muzaffarabad, Azad Kashmir, 13100
Bukhari, 03408133982, medisolepro@gmail.com
About this study
Official title: Comparative Efficacy of Erector Spinae Plane and Quadratus Lumborum Blocks in Managing Postoperative Pain for Total Abdominal Hysterectomy: A Randomized Controlled Trial
TAH, being a large scale gynaecological operation, is a construction bound to cause serious postoperative pain to the patient in that the procedure will inevitably entail massive tissue dissection. Management of this postoperative pain is of utmost significance because poor analgesia may lead to delayed mobilization of the patient, long duration of hospitalization and also general increase in the morbidity of postoperative period. Traditionally, in these facilities, opioid analgesics are the most common and the most popular means of controlling postoperative pain. Nevertheless, the varied and pervasive use of opioids is largely constrained by its well-reported, dose-dependent systemic adverse effects. Nausea, vomiting, sedation, and respiratory depression are complications that severely degrade the recovery process of the patient and reduce his or her satisfaction.
Read the detailed description
Patients who met the inclusion criteria were recruited in the trial after getting approval from the Hospital Ethical Review Committee and REU CPSP. Demographic information such as age, height, weight, body mass index as well as the functional classification (ASA) was documented on a pre-made proforma. Patients were randomized into two groups using a computer-generated randomisation process.
Group A: Received an ultrasound-guided erector spinae plane block at the T9-T10 level using 20 ml of 0.25% bupivacaine.
Group B: Received an ultrasound-guided posterior quadratus lumborum block using 20 ml of 0.25% bupivacaine.
A qualified anaesthesiologist performed each block in aseptic settings prior to surgery. Standardised general anaesthesia was administered to each patient. The Visual Analogue Scale (VAS) was used to quantify pain at rest and on coughing at 2, 6, 12, 18, and 24 hours. Patents with VAS score more than 4, were given rescue analgesia and the cumulative amount of analgesics used in the first 24 hours as well as the time of the first rescue analgesia were recorded. Patient satisfaction with pain treatment as well as adverse effects such nausea, vomiting, and hypotension were tracked for a duration of 24 hours after the surgery
- Conditions
- Post Operative Analgesia
- Being tested
- Erector Spinae Plane Block, Quadratus Lumborum Block (QLB)
- Keywords
- post operative analgesia,, erector spinae plane block, Quadratus Lumborum Blocks, Abdominal Hysterectomy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Erector Spinae Plane BlockProcedure or surgery
Ultrasound-guided erector spinae plane block at the T9-T10 level using 20 ml of 0.25% bupivacaine.
Quadratus Lumborum Block (QLB)Procedure or surgery
Ultrasound-guided posterior quadratus lumborum block using 20 ml of 0.25% bupivacaine.
| Study group | Role | What they receive |
|---|---|---|
| Group A | Active comparator | Not described Receives: Procedure: Erector Spinae Plane Block |
| Group B | Active comparator | Not described Receives: Procedure: Quadratus Lumborum Block (QLB) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Post Operative Pain
Visual Analogue Score a one-dimensional indicator of pain severity. It is made up of a horizontal line that is 10 cm (100 mm) long and has two end points marked "No Pain" (0) and "Worst Possible Pain" (10). On the line, the patient marks the point that most accurately depicts their level of discomfort at 2,4,6,18 \& 24 hours post operatively.
Measured: 24 Hours
Secondary outcomes (4)
Time to first Rescue Analgesia
When a patient's pain score surpasses a certain threshold (e.g., VAS > 4), additional analgesic medication is administered when the primary anaesthetic approach is unable to give sufficient pain relief and the time will be calculated in hours.
Measured: 24 Hourse
Cumulative Opioid consumption
The total amount of opioid medicine needed by the patient over the course of the first 24 hours following surgery in order to sustain sufficient analgesia. This is frequently computed as the Morphine Equivalent Dose (mg) and standardised.
Measured: 24 Hours
Adverse effects
Unwanted and unpleasant effects like nausea, vomiting during 24 hours post operatively
Measured: 24 Hours
Patient Satisfaction
A conventional 5-point Likert scale that ranges from "Very Dissatisfied" to "Very Satisfied" is usually used to gauge the patient's subjective assessment of the level of pain care they got during 24 hours duration post-operatively
Measured: 24 Hours
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 start1 Apr 2026 (estimated)
- Primary completion30 Sep 2026 (estimated)
- Study completion30 Nov 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for Post Operative AnalgesiaStudies 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
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Sheikh Khalifa Bin Zayed Al Nahyan Combined Military Hospital Muzaffarabad
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Hamid Altaf, Sheikh Khalifa Bin Zayed Al Nahyan Combined Military Hospital Muzaffarabad
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07480499
- Sponsor's protocol ID
- ANS-2023-106-3308
- Status last verified
- Mar 2026
- First submitted
- 13 Mar 2026
- Last updated
- 18 Mar 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Korgvee A, Junttila E, Koskinen H, Huhtala H, Kalliomaki ML. Ultrasound-guided quadratus lumborum block for postoperative analgesia: A systematic review and meta-analysis. Eur J Anaesthesiol. 2021 Feb 1;38(2):115-129. doi: 10.1097/EJA.0000000000001368.
PubMed 33186305Adhikary SD, Pruett A, Forero M, Thiruvenkatarajan V. Erector spinae plane block versusquadratus lumborum block: a meta-analysis of randomized controlled trials. Reg Anesth Pain Med. 2021;46(10):854-863.
Chavan R, Goklani A, Chavan G, Mali V. Comparison of anterior quadratus lumborum block versus lumbar erector spinae plane block for postoperative analgesia in total abdominal hysterectomy: A randomized controlled study. Pain Med. 2025;26(1):12-18
Baran O, Sahin A, Arar C. Comparative efficacy of erector spinae plane and quadratus lumborum blocks in managing postoperative pain for total abdominal hysterectomy: A randomized controlled trial. Medicine (Baltimore). 2024 Oct 25;103(43):e40313. doi: 10.1097/MD.0000000000040313.
PubMed 39470511Abdelaziz TSA, Abdou K, Salem M. Erector spinae plane block versus quadratus lumborum block for postoperative analgesia after abdominal hysterectomy: a randomized comparative study. Anaesth Pain Intensive Care. 2024;28(2):333-340.
Zewdu D, Tantu T, Eanga S, Tilahun T. Analgesic efficacy of erector spinae plane block versus transversus abdominis plane block for laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trial. Front Med (Lausanne). 2024 Jul 29;11:1399253. doi: 10.3389/fmed.2024.1399253. eCollection 2024.
PubMed 39135713
Study at a glance
From the registry record, last updated by the sponsor on 18 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Efficacy of Erector Spinae Plane and Quadratus Lumborum Blocks in Managing Postoperative Pain for Total Abdominal Hysterectomy: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07480499
- Acronym / sponsor ID
- ANS-2023-106-3308
- Conditions
- Post Operative Analgesia
- Keywords
- post operative analgesia,, erector spinae plane block, Quadratus Lumborum Blocks, Abdominal Hysterectomy
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Sheikh Khalifa Bin Zayed Al Nahyan Combined Military Hospital MuzaffarabadUniversity, hospital or other
- Study start
- 1 Apr 2026 (estimated)
- Primary completion
- 30 Sep 2026 (estimated)
- Study completion
- 30 Nov 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.
TAH, being a large scale gynaecological operation, is a construction bound to cause serious postoperative pain to the patient in that the procedure will inevitably entail massive tissue dissection. Management of this postoperative pain is of utmost significance because poor analgesia may lead to delayed mobilization of the patient, long duration of hospitalization and also general increase in the morbidity of postoperative period. Traditionally, in these facilities, opioid analgesics are the most common and the most popular means of controlling postoperative pain. Nevertheless, the varied and pervasive use of opioids is largely constrained by its well-reported, dose-dependent systemic adverse effects. Nausea, vomiting, sedation, and respiratory depression are complications that severely degrade the recovery process of the patient and reduce his or her satisfaction.
Detailed description
Patients who met the inclusion criteria were recruited in the trial after getting approval from the Hospital Ethical Review Committee and REU CPSP. Demographic information such as age, height, weight, body mass index as well as the functional classification (ASA) was documented on a pre-made proforma. Patients were randomized into two groups using a computer-generated randomisation process.
Group A: Received an ultrasound-guided erector spinae plane block at the T9-T10 level using 20 ml of 0.25% bupivacaine.
Group B: Received an ultrasound-guided posterior quadratus lumborum block using 20 ml of 0.25% bupivacaine.
A qualified anaesthesiologist performed each block in aseptic settings prior to surgery. Standardised general anaesthesia was administered to each patient. The Visual Analogue Scale (VAS) was used to quantify pain at rest and on coughing at 2, 6, 12, 18, and 24 hours. Patents with VAS score more than 4, were given rescue analgesia and the cumulative amount of analgesics used in the first 24 hours as well as the time of the first rescue analgesia were recorded. Patient satisfaction with pain treatment as well as adverse effects such nausea, vomiting, and hypotension were tracked for a duration of 24 hours after the surgery
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group A | Active comparator | Procedure: Erector Spinae Plane Block |
| Group B | Active comparator | Procedure: Quadratus Lumborum Block (QLB) |
Who may qualify
- Ages
- 35 to 65 years
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Patients aged 35-60 years. ASA physical status I or II. Elective Total Abdominal Hysterectomy under General Anesthesia.
Key exclusion criteria (1 listed)
- Allergy with local anesthetics. Infection in the injection site. Coagulopathy or anticoagulant use. Morbid obesity (BMI > 35 kg/m²).
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 |
|---|---|---|
| Erector Spinae Plane BlockUltrasound-guided erector spinae plane block at the T9-T10 level using 20 ml of 0.25% bupivacaine. | Procedure or surgery | Group A |
| Quadratus Lumborum Block (QLB)Ultrasound-guided posterior quadratus lumborum block using 20 ml of 0.25% bupivacaine. | Procedure or surgery | Group B |
Primary outcome
Post Operative Pain
Time frame: 24 Hours
Visual Analogue Score a one-dimensional indicator of pain severity. It is made up of a horizontal line that is 10 cm (100 mm) long and has two end points marked "No Pain" (0) and "Worst Possible Pain" (10). On the line, the patient marks the point that most accurately depicts their level of discomfort at 2,4,6,18 \& 24 hours post operatively.
4 secondary outcomes
Time to first Rescue Analgesia
Time frame: 24 Hourse
Cumulative Opioid consumption
Time frame: 24 Hours
Adverse effects
Time frame: 24 Hours
Patient Satisfaction
Time frame: 24 Hours
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 18 Mar 2026.
- Background: PubMed 33186305Korgvee A, Junttila E, Koskinen H, Huhtala H, Kalliomaki ML. Ultrasound-guided quadratus lumborum block for postoperative analgesia: A systematic review and meta-analysis. Eur J Anaesthesiol. 2021 Feb 1;38(2):115-129. doi: 10.1097/EJA.0000000000001368.
- BackgroundAdhikary SD, Pruett A, Forero M, Thiruvenkatarajan V. Erector spinae plane block versusquadratus lumborum block: a meta-analysis of randomized controlled trials. Reg Anesth Pain Med. 2021;46(10):854-863.
- BackgroundChavan R, Goklani A, Chavan G, Mali V. Comparison of anterior quadratus lumborum block versus lumbar erector spinae plane block for postoperative analgesia in total abdominal hysterectomy: A randomized controlled study. Pain Med. 2025;26(1):12-18
- Background: PubMed 39470511Baran O, Sahin A, Arar C. Comparative efficacy of erector spinae plane and quadratus lumborum blocks in managing postoperative pain for total abdominal hysterectomy: A randomized controlled trial. Medicine (Baltimore). 2024 Oct 25;103(43):e40313. doi: 10.1097/MD.0000000000040313.
- BackgroundAbdelaziz TSA, Abdou K, Salem M. Erector spinae plane block versus quadratus lumborum block for postoperative analgesia after abdominal hysterectomy: a randomized comparative study. Anaesth Pain Intensive Care. 2024;28(2):333-340.
- Background: PubMed 39135713Zewdu D, Tantu T, Eanga S, Tilahun T. Analgesic efficacy of erector spinae plane block versus transversus abdominis plane block for laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trial. Front Med (Lausanne). 2024 Jul 29;11:1399253. doi: 10.3389/fmed.2024.1399253. eCollection 2024.
- 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 Erector Spinae Plane Block and Quadratus Lumborum Block (QLB) in people with Post Operative Analgesia, run by Sheikh Khalifa Bin Zayed Al Nahyan Combined Military Hospital Muzaffarabad at 1 site in Pakistan.
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 1 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 18 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 Pakistan. 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 Hamid Altaf Altaf (+92 341 4764956, hamidaltaf331@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Post Operative Pain (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 NCT07480499, which also lists 6 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 18 Mar 2026.