Lumbar Disc HerniationTLIP-QIPNCT07750418
Comparison of TLIP Block and QIP Block for Postoperative Analgesia After Lumbar Spine Surgery
An observational study of Lumbar Disc Herniation and Postoperative Pain, run by Vezirköprü State Hospital at 1 site in Turkey (Türkiye).
Trial summary
This study compares two regional anesthesia techniques used for pain control after lumbar spine surgery: the classic thoracolumbar interfascial plane (TLIP) block and the quadratus lumborum-iliac plane (QIP) block. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Lumbar Disc Herniation, Postoperative Pain
- What is being tested?
- Thoracolumbar Interfascial Plane (TLIP) Block of bupivacaine and Quadratus Lumborum-Iliac Plane (QIP) Block
- Type of treatment
- Injection or infusion, Surgery or procedure
- How many people
- 60 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 15 Aug 2026to 31 Dec 2026
- Phase
- Observational
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
Study population: Patients aged 18-65 years, ASA physical status I-II, undergoing elective lumbar discectomy at up to two spinal levels under general anesthesia at Vezirköprü State Hospital, who receive either a classic TLIP block or a QIP block for postoperative analgesia as part of routine clinical practice.
Who may be able to join
- Aged 18-65 years
- ASA physical status I-II
- Undergoing elective lumbar discectomy at up to two spinal levels under general anesthesia
- Receiving classic TLIP block or QIP block for postoperative analgesia as part of routine clinical practice
Who cannot join
- Hypersensitivity or allergy to study medications
- Coagulopathy
- Infection at the injection site
- Severe neurological deficit
- Chronic opioid use
- Advanced hepatic or renal failure
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- Obesity (BMI >35 kg/m2)
- Pregnancy
- ASA physical status III-IV
- Mental retardation
- Inability to provide informed consent
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
Vezirköprü State Hospital
Vezirköprü, Samsun
MEHMET YUSUF YILMAZ, MD, +90 537 816 24 87, myyilmaz55@gmail.com
BETUL YILMAZ, MD, +90 505 035 64 70, betuluslucan@gmail.com
About this study
Official title: Comparison of the Efficacy of Classic Thoracolumbar Interfascial Plane (TLIP) Block and Quadratus Lumborum-Iliac Plane (QIP) Block for Postoperative Analgesia in Patients Undergoing Lumbar Vertebral Surgery: A Prospective Observational Study
This study compares two regional anesthesia techniques used for pain control after lumbar spine surgery: the classic thoracolumbar interfascial plane (TLIP) block and the quadratus lumborum-iliac plane (QIP) block. Patients between 18 and 65 years of age who undergo elective lumbar discectomy (up to two spinal levels) will be observed based on which block their treating anesthesiologist chooses to use as part of routine clinical practice. No randomization or additional intervention beyond standard care will be performed. Researchers will record the total amount of opioid pain medication used in the first 24 hours after surgery, the time until the first request for pain medication, pain scores at several time points after surgery (0, 1, 2, 4, 8, 12, and 24 hours), and any side effects (such as nausea, vomiting, or sedation) or complications related to the block. The aim is to compare the effectiveness and safety of these two techniques in reducing pain and opioid use after lumbar spine surgery.
Read the detailed description
Patients undergoing elective lumbar discectomy at up to two levels, ASA physical status I-II, aged 18-65 years, who receive either a classic TLIP block or a QIP block as part of routine clinical anesthesia practice will be included in this prospective observational study. The choice of block technique is determined solely by the treating anesthesiologist's routine practice, not by study allocation. Both blocks are performed under ultrasound guidance at the end of surgery, before emergence from anesthesia, using bilateral injections of 20 mL (40 mL total) of 0.25% bupivacaine. All patients receive standardized general anesthesia and a multimodal analgesic regimen (intravenous paracetamol, dexketoprofen, and tramadol as rescue analgesia for VAS ≥ 4). Outcomes recorded include total opioid consumption in the first 24 postoperative hours, time to first opioid request, VAS pain scores at PACU (0h), 1, 2, 4, 8, 12, and 24 hours, postoperative side effects (nausea, vomiting, pruritus, sedation, hypotension), and block-related complications (hematoma, local anesthetic systemic toxicity, infection).
- Conditions
- Lumbar Disc Herniation, Postoperative Pain
- Being tested
- Thoracolumbar Interfascial Plane (TLIP) Block of bupivacaine, Quadratus Lumborum-Iliac Plane (QIP) Block
- Keywords
- Thoracolumbar Interfascial Plane Block, Quadratus Lumborum Block, Lumbar Discectomy, Postoperative Analgesia
- Medical subject headings
- Intervertebral Disc Displacement, Pain, Postoperative
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Thoracolumbar Interfascial Plane (TLIP) Block of bupivacaineProcedure or surgery
Also called TLIP Block
Ultrasound-guided injection of 20 mL bilaterally (40 mL total) of 0.25% bupivacaine into the fascial plane between the multifidus and longissimus muscles at the relevant lumbar level, performed at the end of surgery before emergence from anesthesia, as part of routine postoperative analgesia.
Quadratus Lumborum-Iliac Plane (QIP) BlockProcedure or surgery
Also called QIP Block
Ultrasound-guided injection of 20 mL bilaterally (40 mL total) of 0.25% bupivacaine into the interfascial plane between the erector spinae and quadratus lumborum muscles at the iliac crest level, performed at the end of surgery before emergence from anesthesia, as part of routine postoperative analgesia.
| Study group | Role | What they receive |
|---|---|---|
| TLIP Block | Patients who receive a classic thoracolumbar interfascial plane (TLIP) block for postoperative analgesia after lumbar discectomy, as determined by the treating anesthesiologist's routine clinical practice. The block is performed under ultrasound guidance in the fascial plane between the multifidus and longissimus muscles, using bilateral injections of 20 mL (40 mL total) of 0.25% bupivacaine Receives: Procedure: Thoracolumbar Interfascial Plane (TLIP) Block of bupivacaine | |
| QIP Block | Patients who receive a quadratus lumborum-iliac plane (QIP) block for postoperative analgesia after lumbar discectomy, as determined by the treating anesthesiologist's routine clinical practice. The block is performed under ultrasound guidance in the interfascial plane between the erector spinae and quadratus lumborum muscles at the iliac crest level, using bilateral injections of 20 mL (40 mL total) of 0.25% bupivacaine. Receives: Procedure: Quadratus Lumborum-Iliac Plane (QIP) Block |
What is being measured
The primary outcome is the main question the study is designed to answer.
Total Opioid Consumption in the First 24 Postoperative Hours
Cumulative amount of intravenous tramadol (mg) administered as rescue analgesia during the first 24 hours after surgery in each group.
Measured: 0 to 24 hours after surgery
Secondary outcomes (4)
Time to First Opioid Request
Time elapsed from end of surgery to the first patient request for rescue opioid analgesia (VAS ≥ 4)
Measured: Up to 24 hours after surgery
Postoperative Pain Score (Visual Analog Scale)
Pain intensity measured using the Visual Analog Scale (VAS, 0 = no pain, 10 = worst imaginable pain) at PACU (0h) and at 1, 2, 4, 8, 12, and 24 hours after surgery.
Measured: 0, 1, 2, 4, 8, 12, and 24 hours after surgery
Incidence of Postoperative Side Effects
Number of patients experiencing nausea, vomiting, pruritus, sedation, or hypotension after surgery.
Measured: Up to 24 hours after surgery
Incidence of Block-Related Complications
Number of patients experiencing hematoma, local anesthetic systemic toxicity, or infection related to the block procedure.
Measured: Up to 24 hours after surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Aug 2026
- Study start15 Aug 2026 (estimated)
- Primary completion31 Dec 2026 (estimated)
- Study completion31 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for Lumbar Disc HerniationStudies 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
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Vezirköprü State Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- MEHMET YUSUF YILMAZ, MD, Principal investigator, Vezirkopru State Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07750418
- Sponsor's protocol ID
- OMU KAEK 2026/248
- Acronym
- TLIP-QIP
- Status last verified
- Aug 2026
- First submitted
- 1 Aug 2026
- Last updated
- 6 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Tulgar 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 38459608Hand WR, Taylor JM, Harvey NR, Epperson TI, Gunselman RJ, Bolin ED, Whiteley J. Thoracolumbar interfascial plane (TLIP) block: a pilot study in volunteers. Can J Anaesth. 2015 Nov;62(11):1196-200. doi: 10.1007/s12630-015-0431-y. Epub 2015 Jul 7.
PubMed 26149600Yeung J, Small C. Impact of regional analgesia in surgery. Br J Surg. 2021 Sep 27;108(9):1009-1010. doi: 10.1093/bjs/znab214. No abstract available.
PubMed 34131701Andreae MH, Andreae DA. Regional anaesthesia to prevent chronic pain after surgery: a Cochrane systematic review and meta-analysis. Br J Anaesth. 2013 Nov;111(5):711-20. doi: 10.1093/bja/aet213. Epub 2013 Jun 28.
PubMed 23811426Humble SR, Dalton AJ, Li L. A systematic review of therapeutic interventions to reduce acute and chronic post-surgical pain after amputation, thoracotomy or mastectomy. Eur J Pain. 2015 Apr;19(4):451-65. doi: 10.1002/ejp.567. Epub 2014 Aug 4.
PubMed 25088289Dietz N, Sharma M, Adams S, Alhourani A, Ugiliweneza B, Wang D, Nuno M, Drazin D, Boakye M. Enhanced Recovery After Surgery (ERAS) for Spine Surgery: A Systematic Review. World Neurosurg. 2019 Oct;130:415-426. doi: 10.1016/j.wneu.2019.06.181. Epub 2019 Jul 2.
PubMed 31276851Bajwa SJ, Haldar R. Pain management following spinal surgeries: An appraisal of the available options. J Craniovertebr Junction Spine. 2015 Jul-Sep;6(3):105-10. doi: 10.4103/0974-8237.161589.
PubMed 26288544