Comparison of the Intraoperative and Postoperative Effects of Ultrasound-guided Erector Spina Plane Block and Posterior Quadratus Lumborum Block in Patients Undergoing Lumbar Stabilization Surgery

Study Overview
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Brief Summary
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The investigators aimed to compare the effects of ultrasound guided erector spina plan block and posterior quadratus lumborum block on intraoperative and postoperative opioid consumption in patients who will undergo short segment lumbar stabilization surgery.

Detailed Description
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All participants will be monitored with ECG, SpO2, non-invasive blood pressure. In induction, 1mg/kg 2% lidocaine, 2-3mg/kg propofol, 1mcg/kg fentanyl, 2mg midazolam, 0.6 mg/kg rocuronium will be used. Anesthesia depth will be monitored with BIS (bispectral index), and anesthesia will be maintained with 50% oxygen-air mixture and sevoflurane. After patient intubation, invasive artery cannulation will be performed on the non-dominant hand, and the patients will be placed in a prone position. 20 cc bupivacaine of 0.25% will be administered to both regions bilaterally, by following the rules of asepsis, with a 10 cm pajunk needle accompanied by USG, the needle site will be confirmed with 3 mm saline. BIS will be kept in the range of 40-50 throughout the case, and invasive arterial monitoring will be performed. 1 g paracetamol, 1 mg/kg tramadol and 4 mg ondansetron will be administered to the patients 30 minutes before the end of the surgery. After appropriate extubation and wakefulness, patients will be transferred to the postoperative anesthesia care unit (PACU), where they will be followed for 24 hours. An intravenous (IV) patient-controlled analgesia device (PCA) containing 100ml of tramadol at a concentration of 4mg/cc will be inserted. No infusion will be given, and the bolus dose will be set to 20mg, with a lock time of 20 minutes. In the postoperative period, 50 mg of dexketoprofen will be administered every 8 hours. VAS values, vital signs, and possible opioid side effects of the patients at 0, 1, 2, 6, 12 and 24 hours will be recorded. After completing 24 hours, the patient will be separated from the IV PCA device and transferred to the service.

Official Title
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Comparison of the Intraoperative and Postoperative Effects of Ultrasound-guided Erector Spina Plane Block and Posterior Quadratus Lumborum Block in Patients Undergoing Lumbar Stabilization Surgery

Conditions
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Postprocedural Analgesia, Opioid Consumption, Erector Spina Plan Block, Quadratus Lumborum Block

Intervention / Treatment
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* Procedure: Peripheral nerve block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who will undergo lumbar stabilization operation Between the ages of 18-65 Both genders ASA I-III risk group Exclusion Criteria: Patients who did not accept the study Patients younger than 18 years old Patients older than 65 years Patients with an ASA score greater than III Patients with an active infection in the area to be blocked Patients with a long bleeding time Those who are pregnant Patients with kidney failure Patients with liver failure Patients with BMI<18 and BMI>30 Those who are allergic to local anesthetics Patients who have had previous lumbar surgery Uncooperative or mentally retarded patients

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Erector Spina Plan Block Group (Group E)<br>Patients who underwent erector spina plane block before initiation of surgery after induction of anesthesia | Procedure: Peripheral nerve block<br>* Ultrasound guided peripheral nerve block<br>|
| Posterior Quadratus Lumborum Block Group ( Group Q)<br>Patients who underwent posterior quadratus lumborum block block before initiation of surgery after induction of anesthesia | Procedure: Peripheral nerve block<br>* Ultrasound guided peripheral nerve block<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| İntraoperative remifentanil consumption | The investigators aimed to compare intraoperative remifentanil consumption of two groups | At the end of the intraoperative period | 
| Postoperative tramadol consumption | The investigators aimed to compare postoperative tramadol consumption of two groups | The investigators will record at postoperative 0. hour | 
| Postoperative tramadol consumption | The investigators aimed to compare postoperative tramadol consumption of two groups | The investigators will record at postoperative 1. hour | 
| Postoperative tramadol consumption | The investigators aimed to compare postoperative tramadol consumption of two groups | The investigators will record at postoperative 2. hour | 
| Postoperative tramadol consumption | The investigators aimed to compare postoperative tramadol consumption of two groups | The investigators will record at postoperative 6. hour | 
| Postoperative tramadol consumption | The investigators aimed to compare postoperative tramadol consumption of two groups | The investigators will record at postoperative 12. hour | 
| Postoperative tramadol consumption | The investigators aimed to compare postoperative tramadol consumption of two groups | The investigators will record at postoperative 24. hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative nausea and vomiting | Whether there is postoperative nausea and vomiting will be questioned by the investigators. Yes or no will be marked in the table. | The investigators will record within 24 hours postoperatively. | 
| Postoperative pruritus | Whether there is postoperative pruritus will be questioned by the investigators. Yes or no will be marked in the table. | The investigators will record within 24 hours postoperatively. | 
| Postoperative visual analog scale | The investigators aimed to compare patient's visual analog scales of two groups. The visual pain scale is measured with a ruler from 0 to 10 cm. 0 indicates no pain, 10 indicates severe pain. | The investigators will record at postoperative 0. hour | 
| Postoperative visual analog scale | The investigators aimed to compare patient's visual analog scales of two groups. The visual pain scale is measured with a ruler from 0 to 10 cm. 0 indicates no pain, 10 indicates severe pain. | We will record at postoperative 1. hour | 
| Postoperative visual analog scale | The investigators aimed to compare patient's visual analog scales of two groups. The visual pain scale is measured with a ruler from 0 to 10 cm. 0 indicates no pain, 10 indicates severe pain. | The investigators will record at postoperative 2. hour | 
| Postoperative visual analog scale | The investigators aimed to compare patient's visual analog scales of two groups. The visual pain scale is measured with a ruler from 0 to 10 cm. 0 indicates no pain, 10 indicates severe pain. | The investigators will record at postoperative 6. hour | 
| Postoperative visual analog scale | The investigators aimed to compare patient's visual analog scales of two groups. The visual pain scale is measured with a ruler from 0 to 10 cm. 0 indicates no pain, 10 indicates severe pain. | The investigators will record at postoperative 12. hour | 
| Postoperative visual analog scale | The investigators aimed to compare patient's visual analog scales of two groups. The visual pain scale is measured with a ruler from 0 to 10 cm. 0 indicates no pain, 10 indicates severe pain. | The investigators will record at postoperative 24. hour |