Quadro-Iliac Plane Block for Pain Control After Posterior Spinal Instrumentation Surgery

Summary

Posterior spinal instrumentation can cause significant postoperative pain due to extensive muscle dissection, manipulation of bone tissue, and implant placement. Providing optimal analgesia in the postoperative period is important for patients' functional recovery and early mobilization. Inadequate control of postoperative pain may delay recovery, increase the risk of opioid dependence, and lead to respiratory complications. Although opioid analgesics are effective in reducing pain during the postoperative period, they are associated with side effects such as nausea, vomiting, respiratory depression, and the risk of dependence. Therefore, the use of non-opioid analgesic approaches is important for patient safety and comfort. For these reasons, regional analgesia techniques such as the modified thoracolumbar interfascial plane (TLIP) block and the erector spinae plane (ESP) block have recently become increasingly popular for postoperative pain control. The quadro-iliac plane block is a novel technique that targets the attachment area of the posterior surface of the quadratus lumborum muscle on the inner surface of the iliac crest. In this block, the spread of local anesthetic along the fascial planes surrounding the quadratus lumborum muscle may provide an anatomical mechanism contributing to analgesia of the lumbosacral, paraspinal, lower abdominal, and gluteal regions. However, as the quadro-iliac plane block is a new technique, there are not yet sufficient studies on this topic in the literature. The primary objective of our study is to evaluate the effect of ultrasound-guided quadro-iliac plane block (QIPB) on postoperative opioid consumption after posterior spinal instrumentation. The secondary objectives are to compare opioid-related side effects, such as nausea, vomiting, and respiratory depression, as well as postoperative NRS (Numeric Rating Scale) pain scores between the groups.

Timeline

Start

2026-08-01

Primary completion

2027-07

Completion

2027-07

Publications

• Results Turan 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.
• Results Ciftci B, Cetinkal A, Alver S, Ahiskalioglu A. Quadro-iliac plane block for lumbar multi-level instrumentation surgery: far away from the surgical area. Minerva Anestesiol. 2025 Apr;91(4):358-359. doi: 10.23736/S0375-9393.24.18680-4. Epub 2024 Dec 10. No abstract available.
• Results Zamudio D, Fernandez L, Rodriguez A, Delgado D. Postoperative erector spinae plane block does not reduce morphine consumption after lumbar spinal fusion: A randomized controlled trial. J Clin Anesth. 2025 Nov;107:112022. doi: 10.1016/j.jclinane.2025.112022. Epub 2025 Sep 26.

Drugs

Indications

No indication recorded.