This randomized clinical trial aims to evaluate and compare the analgesic efficacy and functional outcomes of the quadro-iliac plane block (QIPB) and the erector spinae plane block (ESPB) in patients undergoing lumbar stabilization surgery. The primary outcome is the Numeric Rating Scale (NRS) within the first 48 hours after surgery. Secondary outcomes include postoperative total opioid consumption, incidence of quadriceps motor block, time to first ambulation, block performance time, falls, length of hospital stay, block-related complications (hematoma, local anesthetic systemic complications, vascular puncture, and infection), patient satisfaction assessed using a Likert scale, and incidence of postoperative nausea and vomiting.
Age between 18 and 80 years
American Society of Anesthesiologists physical status I-III
Scheduled for elective primary lumbar stabilization surgery
Surgery planned under general anesthesia
Refusal to participate
Revision lumbar stabilization surgery
Contraindication to regional anesthesia
Contraindication to peripheral nerve/plane block
Parallel
Quadro iliac Plane Block
Procedure/SurgeryParticipants allocated to the QIPB group will receive an ultrasound-guided quadro-iliac plane block after the induction of general anesthesia. Following standard aseptic preparation, 30 mL of 0.25% bupivacaine will be administered into the target fascial plane under ultrasound guidance after confirming the absence of blood on aspiration.
Postoperative pain scores
Postoperative pain intensity will be assessed using an 11-point Numeric Rating Scale (NRS), where 0 indicates no pain and 10 indicates the worst imaginable pain. Pain scores at rest will be recorded in the post-anesthesia care unit and at postoperative 6, 24, 36, and 48 hours. Pain scores during movement will be assessed during passive flexion of the operated hip at postoperative 6, 24, 36, and 48 hours.
Postoperative opioid consumption
Total postoperative opioid consumption will be recorded and cumulative opioid consumption will be calculated at postoperative 24 and 48 hours.
Incidence of quadriceps motor block
Quadriceps motor block will be assessed using knee extension testing and graded as: 0 = normal strength 1. = paresis 2. = paralysis. Motor block incidence will be defined as the presence of paresis or paralysis.
Time to first ambulation
Time from the end of surgery to the first successful ambulation.
Patient satisfaction
Patient satisfaction with postoperative analgesia will be assessed using a Likert scale.
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