quadratus lumborum block for lumbar spinal surgery

Conditions: Lumbar Disc Herniation

Summary: spine surgery in thoracolumbar region is one of the most common surgeries performed for the treatment of leg and back pain. pain management is especially important for these patients since chronic pain often occurs after surgery. severe pain may occur at postoperative period in patients following lumbar disc herniation (ldh) operation. postoperative effective pain treatment provides early mobilization and shorter hospital stay, thus complications due to hospitalization such as infection and thromboembolism may be reduced. ultrasound-guided quadratus lumborum block (qlb) is a fascial plane block where local anesthetic is injected adjacent to the quadratus lumborum muscle with the goal of anesthetizing the thoracolumbar nerves. the aim of this study is to evaluate the efficacy of us-guided qlb for postoperative analgesia management after lumbar disc herniation-laminectomy surgery. the primary aim is to evaluate postoperative pain scores (vas), the secondary aim is to evaluate use of rescue analgesia and adverse effects (allergic reaction, nausea, vomiting).

spine surgery in thoracolumbar region is one of the most common surgeries performed for the treatment of leg and back pain. pain management is especially important for these patients since chronic pain often occurs after surgery. severe pain may occur at postoperative period in patients following lumbar disc herniation (ldh) operation. postoperative effective pain treatment provides early mobilization and shorter hospital stay, thus complications due to hospitalization such as infection and thromboembolism may be reduced. opioids are one of the most preferred drugs among the analgesic agents. parenteral opioids are generally performed for patients after surgery. however opioids have undesirable adverse events such as nausea, vomiting, itching, sedation and respiratory depression (opioid-related adverse events). various methods may be performed to reduce the use of systemic opioids and for effective pain treatment. us-guided interfascial plane blocks have been used increasily due to the advantages of ultrasound in anesthesia practice. ultrasound-guided quadratus lumborum block (qlb) is a fascial plane block where local anesthetic is injected adjacent to the quadratus lumborum muscle with the goal of anesthetizing the thoracolumbar nerves. the aim of this study is to evaluate the efficacy of us-guided qlb for postoperative analgesia management after lumbar disc herniation-laminectomy surgery. the primary aim is to evaluate postoperative pain scores (vas), the secondary aim is to evaluate use of rescue analgesia and adverse effects (allergic reaction, nausea, vomiting).

Eligibility criteria:
inclusion criteria: * american society of anesthesiologists (asa) classification i-ii * scheduled for lumbar disc herniation surgery under general anesthesia exclusion criteria: * bleeding diathesis * receiving anticoagulant treatment * known local anesthetics and opioid allergy * infection of the skin at the site of the needle puncture * pregnancy or lactation * patients who do not accept the procedure

Keywords: lumbar disc herniation postoperative pain management quadratus lumborum block