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CTRI Number  CTRI/2025/11/097396 [Registered on: 13/11/2025] Trial Registered Prospectively
Last Modified On: 12/11/2025
Post Graduate Thesis  Yes 
Type of Trial  Interventional 
Type of Study   Surgical/Anesthesia 
Study Design  Randomized, Parallel Group, Active Controlled Trial 
Public Title of Study   A Study on How Modern Nerve Blocks Can Reduce Painkiller Use and Improve Recovery After Minimally Invasive Kidney Surgery  
Scientific Title of Study   Ultrasound guided Quadratus lumborum block and Erector spinae block on Opioid sparing effect and quality of recovery in minimally invasive Nephrectomy A Prospective Randomized Comparative study 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
ANA/QEN/095, version 1, dated 7/5/2025  Protocol Number 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Nandikonda Akhila 
Designation  MD Anaesthesia [junior resident] 
Affiliation  Nizams institute of medical science  
Address  Room 6,SPECIALITY BLOCK OT, 3rd floor,Department of Anaesthesia, Nizams institute of medical sciences, , Panjagutta, ,Hyderabad

Hyderabad
TELANGANA
500082
India 
Phone  8106916091  
Fax    
Email  Nandikondaakhila9384@gmail.com  
 
Details of Contact Person
Scientific Query  
Name  Dr Archana Pathy 
Designation  Additional professor, Department of Anaesthesia 
Affiliation  Nizams institute of medical sciences  
Address  Room 1, mellinium block OT, 1st floor, Department of Anaesthesia, Nizams institute of medical sciences, Panjagutta, Hyderabad

Hyderabad
TELANGANA
500082
India 
Phone  8885494278  
Fax    
Email  docarchana.pathy@gmail.com  
 
Details of Contact Person
Public Query  
Name  Dr Archana Pathy 
Designation  Additional professor, Department of Anaesthesia 
Affiliation  Nizams institute of medical sciences  
Address  Room 1, mellinium block OT, 1st floor, Department of Anaesthesia, Nizams institute of medical sciences, Panjagutta, Hyderabad

Hyderabad
TELANGANA
500082
India 
Phone  8885494278  
Fax    
Email  docarchana.pathy@gmail.com  
 
Source of Monetary or Material Support  
NIL 
 
Primary Sponsor  
Name  Dr NANDIKONDA AKHILA 
Address  Room 6, speciality block OT, 3rd floor, Department of Anaesthesia, Nizams institute of medical sciences, panjagutta, hyderabad , pincode 500082 
Type of Sponsor  Other [Self] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr NANDIKONDA AKHILA  NIZAMS INSTITUTE OF MEDICAL SCIENCES  Roon number 6, 3rd floor, Speciality block OT, Department of Anaesthesia, Panjagutta, Hyderabad
Hyderabad
TELANGANA 		 8106916091

nandikondaakhila9384@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
NIMS INSTITUTIONAL ETHICS COMMITTEE  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: N00-N99||Diseases of the genitourinary system,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  ERECTER SPINAE BLOCK  Erecter spinae block : A curvilinear probe ( 2.5 to7.5HZ ) and a 23-gauge Quincke’s needle will be used. Upon positioning patients in a lateral position, the T8 spinous process identifed on the midline of the spine using a curvilinear probe. Subsequently, the ultrasound probe will be moved 2–3 cm laterally to locate the hyper echogenicity of the T8 transverse process and identify the erector spinae muscle. Using an in-plane technique,a 23-GZ needle will be advanced in a cranio-caudal direction until the tip of the needle reached the tip of the T8 transverse process. The correct position of the needle tip will be confirmed by hydrodissection of the interfascial plane . Under ultrasound guidance, a solution comprising 10 ml of 2% lidocaine,10 ml of 0.5% bupivacaine will be given and the spread of local anesthetics between the transverse processes and the erector spinae muscle will be observed in real time. Then hemodynamic response monitored during incision and ever15 minutes itraoperatively. 
Intervention  QUADRATUS LAMBORUM BLOCK  Quadratus lumborum block: Patients will be positioned in lateral decubitus position with operative side up. pQLB(QL2) will be performed under direct visualization using a curvilinear ultrasound probe. Probe will be placed in transverse orientation at midaxillary line and sliding it posteriorly, fascial plane between the posterior aspect of the QL muscle and the middle layer of the thoracolumbar fascia will be identified, Quincke’s 23G needle will be inserted in plane from anterior to posterior, a solution comprising 10 ml of 2% lidocaine and 10 ml of 0.5% bupivacaine will be injected toward posterior surface of QL muscle and the spread of local anesthetic will be observed in real time. Then hemodyhamic response is monitored during incision and every 15 minutes intraoperatively. 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  60.00 Year(s)
Gender  Both 
Details  ASA 1-3, undergoing elective laproscopic or robotic nephrectomy
Willing to participate
 
 
ExclusionCriteria 
Details  1.Allergy to local anesthetics.
2. BMI more than 35 kg/m2
3. History of mental illness or taking psychotropic drugs.
4. Long-term use of analgesics or sedatives.
5. History of drug abuse, alcohol, or opioid abuse.
6. Chronic pain or recent acute pain
 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   An Open list of random numbers 
Blinding/Masking   Double Blind Double Dummy 
Primary Outcome  
Outcome  TimePoints 
To evaluate and compare intraop opiod consumption after usg guided quadratus lamborum block(QLB) and erector spinae block(ESB) in minimally invasive nephrectomy.  Baseline,at time of intubation, time of incision, then every 5 min intraop 
 
Secondary Outcome  
Outcome  TimePoints 
o To assess the quality of recovery in postop period
o To evaluate the requirement of rescue analgesia
o To assess complications (hypotension, bradycardia, nausea& vomiting)
 		 24 hours postoperative period 
 
Target Sample Size   Total Sample Size="60"
Sample Size from India="60" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   01/12/2025 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary   Effective pain control is an essential component of enhanced recovery after surgery, particularly in minimally invasive nephrectomy. Although laparoscopic and robotic techniques reduce surgical trauma, patients may still experience significant postoperative pain that can delay recovery and increase opioid requirements. Opioid-based analgesia, while effective, is associated with adverse effects such as nausea, vomiting, respiratory depression, and delayed mobilization, all of which can impair the quality of recovery.
In recent years, ultrasound-guided regional anesthesia techniques such as the Quadratus Lumborum Block (QLB) and the Erector Spinae Plane Block (ESPB) have emerged as promising alternatives for postoperative analgesia. Both techniques provide effective pain relief by blocking somatic and visceral pain pathways, but their relative efficacy and impact on opioid consumption and overall recovery after minimally invasive nephrectomy remain uncertain.
This prospective randomized comparative study aims to evaluate and compare the opioid-sparing effects and quality of recovery between ultrasound-guided Quadratus Lumborum Block and Erector Spinae Plane Block in patients undergoing minimally invasive nephrectomy. By identifying the more effective technique, the study seeks to contribute to improved postoperative pain management, faster recovery, and enhanced patient satisfaction while minimizing opioid-related complications.
 
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