Quadratus Lumborum Nerve BlockESP-QLBNCT07301528
Comparison of ESP and QL Blocks for Postoperative Pain in Pediatric Appendectomy (ESP-QLB)
A study testing Quadratus Lumborum Block (QLB) and Erector Spinae Plane Block in people with Quadratus Lumborum Nerve Block and Erector Spinae Block, run by Zeycan Kahya at 2 sites in Turkey (Türkiye).
Trial summary
This prospective randomized controlled clinical trial aims to compare the analgesic effectiveness of the Erector Spinae Plane (ESP) block and the Quadratus Lumborum (QL) block in pediatric patients undergoing appendectomy. Read more about this study
- Who is it for?
- Ages 3 to 13 years
- Conditions the study is for
- Quadratus Lumborum Nerve Block, Erector Spinae Block
- What is being tested?
- Quadratus Lumborum Block (QLB) and Erector Spinae Plane Block
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 2 sitesTurkey (Türkiye)
- Study dates
- 13 Dec 2025to 28 Apr 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
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 3 to 13 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Patients aged 3-13 years
- Diagnosis of acute appendicitis requiring appendectomy
- ASA physical status I-II
- Planned general anesthesia with intraoperative regional block (ESP or QL block)
- Written informed consent obtained from parents or legal guardians
Who cannot join
- Refusal of regional block by family or anesthesia team
- Coagulopathy or anticoagulant medication use
- Local infection at the block injection site
- Known allergy or contraindication to local anesthetics
- Neurological or neuromuscular disorders
- Cognitive impairment preventing postoperative pain assessment
- Conversion to open surgery
- Intraoperative complications requiring deviation from study protocol
Trial locations and contacts
2 sites in 1 country.
Turkey (Türkiye)2 sites
Kutahya City Hospital Anesthesia and Reanimation Department
Kütahya, Kütahya, 43100
Kutahya City Hospital
Kütahya, 43100
About this study
Official title: Comparative Effects of Erector Spinae Plane and Quadratus Lumborum Blocks on Postoperative Pain and Analgesic Requirement in Pediatric Appendectomy: A Prospective Randomized Controlled Trial
This prospective randomized controlled clinical trial aims to compare the analgesic effectiveness of the Erector Spinae Plane (ESP) block and the Quadratus Lumborum (QL) block in pediatric patients undergoing appendectomy. Both regional anesthesia techniques have been shown to reduce opioid requirements and improve postoperative recovery in children; however, there is limited evidence directly comparing their efficacy. In this study, eligible participants will be randomly assigned to receive either an ESP or a QL block in addition to standard general anesthesia before surgical incision. Postoperative outcomes will include pain scores, total opioid consumption, time to first analgesic requirement, mobilization time, parental satisfaction, length of hospital stay, block-related complications and block performance time. The findings are expected to guide clinicians in selecting the most effective regional anesthesia technique for postoperative pain control in pediatric appendectomy.
Read the detailed description
Appendectomy is one of the most common emergency surgical procedures in children, and effective postoperative analgesia plays a key role in patient comfort, early mobilization, and reduced opioid exposure. Regional anesthesia techniques have gained increasing importance in pediatric anesthesia due to their opioid-sparing effect and favorable safety profile. Among these techniques, the Erector Spinae Plane (ESP) block and the Quadratus Lumborum (QL) block have shown promising results; however, there is a lack of high-quality randomized controlled trials directly comparing their clinical efficacy in pediatric appendectomy.
This study will prospectively enroll pediatric patients between 3 and 13 years of age who are scheduled to undergo appendectomy. After obtaining informed parental consent, participants will be randomly allocated to either the ESP block group or the QL block group. All blocks will be performed under ultrasound guidance using 0.25% bupivacaine at a dose of 0.5 mL/kg following the induction of general anesthesia. Standardized postoperative analgesia protocols will be applied to all participants.
Pain scores will be measured at predefined time points using a validated pediatric pain scale. Secondary outcomes will include total opioid consumption during the first 24 hours, the time to first rescue analgesic requirement, mobilization time, length of hospital stay, parental satisfaction scores, and any block-related complications. Patient data will be collected by trained investigators who will be blinded to group allocation.
The goal of this trial is to determine whether ESP or QL block provides superior postoperative pain control and recovery in pediatric appendectomy. The results may contribute to evidence-based recommendations for regional anesthesia selection in pediatric surgical practice.
- Being tested
- Quadratus Lumborum Block (QLB), Erector Spinae Plane Block
- Keywords
- Erector Spinae Plane Block, Quadratus Lumborum Block, Regional Anesthesia, Pediatric Appendectomy, Postoperative Pain, Ultrasound-Guided Nerve Blocks, Analgesic Requirement
- Medical subject headings
- Pain, Postoperative
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Quadratus Lumborum Block (QLB)Drug
Ultrasound-guided transmuscular QL block performed under general anesthesia using 0.25% bupivacaine (0.5 mL/kg) before surgical incision.
Erector Spinae Plane BlockDrug
Ultrasound-guided ESP block at the L1 level under general anesthesia using 0.25% bupivacaine (0.5 mL/kg) before surgical incision.
| Study group | Role | What they receive |
|---|---|---|
| QLB Block | Experimental | Ultrasound-guided transmuscular QL block using 0.25% bupivacaine (0.5 mL/kg) before surgical incision. Receives: Drug: Quadratus Lumborum Block (QLB) |
| ESP Block | Active comparator | Ultrasound-guided ESP block at the L1 level using 0.25% bupivacaine (0.5 mL/kg) before surgical incision. Receives: Drug: Erector Spinae Plane Block |
What is being measured
The primary outcome is the main question the study is designed to answer.
Postoperative Pain Score
Pain intensity will be evaluated at rest using the Oucher Pain Rating Scale. Higher scores indicate greater pain.
Measured: Pain scores will be assessed at 1, 6, 12, and 24 postoperative hours.
Secondary outcomes (7)
Total Analgesic Consumption
Total dose of analgesic medications (NSAIDs and/or non-opioid analgesics) administered within the first 24 hours after surgery will be recorded. Higher values indicate greater analgesic requirement.
Measured: Recorded during the first 24 hours after surgery
Time to First Analgesic Requirement
Time interval between the end of surgery and the first administration of rescue analgesia will be recorded in minutes. Longer intervals indicate better analgesic effectiveness.
Measured: From the end of surgery until the first documented analgesic requirement, assessed up to 24 hours postoperatively
Time to Mobilization
Time from the end of surgery until the patient is able to ambulate with assistance or independently will be recorded in minutes. Shorter time indicates faster functional recovery.
Measured: From the end of surgery until the first successful ambulation with or without assistance, assessed up to 24 hours postoperatively
Length of Hospital Stay
Duration of hospitalization will be recorded from admission to discharge and expressed in hours. Longer duration indicates delayed recovery.
Measured: From the end of surgery until hospital discharge, typically within 24-48 hours.
Parents' Postoperative Pain Measure (PPPM)
Postoperative pain will be evaluated by parents using the Parents' Postoperative Pain Measure (PPPM). Higher scores indicate greater pain intensity.
Measured: Assessed at 1, 6, 12, and 24 hours postoperatively
Block-Related Complications
ny adverse events potentially related to the regional block (e.g., local hematoma or bruising, infection at the injection site, neurological symptoms, or suspected local anesthetic systemic toxicity) will be recorded as present or absent.
Measured: From block performance until the end of surgery and during the first 24 hours postoperatively
Block performance time
Block performance time was defined as the time (in seconds) from the initial placement of the ultrasound probe on the skin to the completion of local anesthetic injection. The duration was recorded by an independent observer using a stopwatch.
Measured: During block performance, prior to surgical incision
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Dec 2025
- Study start13 Dec 2025
- Primary completion15 Apr 2026
- Study completion28 Apr 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Quadratus Lumborum Nerve BlockStudies 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
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be randomly assigned in a 1:1 ratio to one of two parallel intervention arms: ultrasound-guided Erector Spinae Plane block or ultrasound-guided Quadratus Lumborum block, both performed under general anesthesia before surgical incision.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 60 participants (actual)
Sponsor and investigators
- Lead sponsor
- Zeycan Kahya
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Zeycan Kahya, Kutahya City Hospital
- Investigators
- Süleyman Camgöz, Principal investigator, Kutahya Health Sciences University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07301528
- Sponsor's protocol ID
- KSBU-ESPQL-2026
- Acronym
- ESP-QLB
- Status last verified
- Apr 2026
- First submitted
- 16 Nov 2025
- Last updated
- 5 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided: The sharing of IPD is permitted under the condition that the organisation requesting its sharing provides a valid reason.
Study at a glance
From the registry record, last updated by the sponsor on 5 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects of Erector Spinae Plane and Quadratus Lumborum Blocks on Postoperative Pain and Analgesic Requirement in Pediatric Appendectomy: A Prospective Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07301528
- Acronym / sponsor ID
- ESP-QLB / KSBU-ESPQL-2026
- Keywords
- Erector Spinae Plane Block, Quadratus Lumborum Block, Regional Anesthesia, Pediatric Appendectomy, Postoperative Pain, Ultrasound-Guided Nerve Blocks, Analgesic Requirement
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 60 participants (actual)
- Lead sponsor
- Zeycan KahyaUniversity, hospital or other
- Study start
- 13 Dec 2025 (actual)
- Primary completion
- 15 Apr 2026 (actual)
- Study completion
- 28 Apr 2026 (actual)
- First posted
- 24 Dec 2025 (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.
This prospective randomized controlled clinical trial aims to compare the analgesic effectiveness of the Erector Spinae Plane (ESP) block and the Quadratus Lumborum (QL) block in pediatric patients undergoing appendectomy. Both regional anesthesia techniques have been shown to reduce opioid requirements and improve postoperative recovery in children; however, there is limited evidence directly comparing their efficacy. In this study, eligible participants will be randomly assigned to receive either an ESP or a QL block in addition to standard general anesthesia before surgical incision. Postoperative outcomes will include pain scores, total opioid consumption, time to first analgesic requirement, mobilization time, parental satisfaction, length of hospital stay, block-related complications and block performance time. The findings are expected to guide clinicians in selecting the most effective regional anesthesia technique for postoperative pain control in pediatric appendectomy.
Detailed description
Appendectomy is one of the most common emergency surgical procedures in children, and effective postoperative analgesia plays a key role in patient comfort, early mobilization, and reduced opioid exposure. Regional anesthesia techniques have gained increasing importance in pediatric anesthesia due to their opioid-sparing effect and favorable safety profile. Among these techniques, the Erector Spinae Plane (ESP) block and the Quadratus Lumborum (QL) block have shown promising results; however, there is a lack of high-quality randomized controlled trials directly comparing their clinical efficacy in pediatric appendectomy.
This study will prospectively enroll pediatric patients between 3 and 13 years of age who are scheduled to undergo appendectomy. After obtaining informed parental consent, participants will be randomly allocated to either the ESP block group or the QL block group. All blocks will be performed under ultrasound guidance using 0.25% bupivacaine at a dose of 0.5 mL/kg following the induction of general anesthesia. Standardized postoperative analgesia protocols will be applied to all participants.
Pain scores will be measured at predefined time points using a validated pediatric pain scale. Secondary outcomes will include total opioid consumption during the first 24 hours, the time to first rescue analgesic requirement, mobilization time, length of hospital stay, parental satisfaction scores, and any block-related complications. Patient data will be collected by trained investigators who will be blinded to group allocation.
The goal of this trial is to determine whether ESP or QL block provides superior postoperative pain control and recovery in pediatric appendectomy. The results may contribute to evidence-based recommendations for regional anesthesia selection in pediatric surgical practice.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Participants will be randomly assigned in a 1:1 ratio to one of two parallel intervention arms: ultrasound-guided Erector Spinae Plane block or ultrasound-guided Quadratus Lumborum block, both performed under general anesthesia before surgical incision.
| Arm | Type | Receives |
|---|---|---|
| QLB Block | Experimental | Drug: Quadratus Lumborum Block (QLB)Ultrasound-guided transmuscular QL block using 0.25% bupivacaine (0.5 mL/kg) before surgical incision. |
| ESP Block | Active comparator | Drug: Erector Spinae Plane BlockUltrasound-guided ESP block at the L1 level using 0.25% bupivacaine (0.5 mL/kg) before surgical incision. |
Who may qualify
- Ages
- 3 to 13 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (5 listed)
- Patients aged 3-13 years
- Diagnosis of acute appendicitis requiring appendectomy
- ASA physical status I-II
- Planned general anesthesia with intraoperative regional block (ESP or QL block)
- Written informed consent obtained from parents or legal guardians
Key exclusion criteria (8 listed)
- Refusal of regional block by family or anesthesia team
- Coagulopathy or anticoagulant medication use
- Local infection at the block injection site
- Known allergy or contraindication to local anesthetics
- Neurological or neuromuscular disorders
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 |
|---|---|---|
| Quadratus Lumborum Block (QLB)Ultrasound-guided transmuscular QL block performed under general anesthesia using 0.25% bupivacaine (0.5 mL/kg) before surgical incision. | Drug | QLB Block |
| Erector Spinae Plane BlockUltrasound-guided ESP block at the L1 level under general anesthesia using 0.25% bupivacaine (0.5 mL/kg) before surgical incision. | Drug | ESP Block |
Primary outcome
Postoperative Pain Score
Time frame: Pain scores will be assessed at 1, 6, 12, and 24 postoperative hours.
Pain intensity will be evaluated at rest using the Oucher Pain Rating Scale. Higher scores indicate greater pain.
7 secondary outcomes
Total Analgesic Consumption
Time frame: Recorded during the first 24 hours after surgery
Time to First Analgesic Requirement
Time frame: From the end of surgery until the first documented analgesic requirement, assessed up to 24 hours postoperatively
Time to Mobilization
Time frame: From the end of surgery until the first successful ambulation with or without assistance, assessed up to 24 hours postoperatively
Length of Hospital Stay
Time frame: From the end of surgery until hospital discharge, typically within 24-48 hours.
Parents' Postoperative Pain Measure (PPPM)
Time frame: Assessed at 1, 6, 12, and 24 hours postoperatively
Block-Related Complications
Time frame: From block performance until the end of surgery and during the first 24 hours postoperatively
Block performance time
Time frame: During block performance, prior to surgical incision
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 May 2026.
- Individual participant dataSharing planned: Undecided. The sharing of IPD is permitted under the condition that the organisation requesting its sharing provides a valid reason.
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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. This study is not recruiting at the moment.
Süleyman Camgöz principal investigator
Kutahya Health Sciences University
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Quadratus Lumborum Block (QLB) and Erector Spinae Plane Block in people with Quadratus Lumborum Nerve Block and Erector Spinae Block, run by Zeycan Kahya at 2 sites 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 5 inclusion and 8 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: finished, as of the sponsor's last update on 5 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Postoperative Pain Score (time frame: Pain scores will be assessed at 1, 6, 12, and 24 postoperative hours.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 5 May 2026.