Thoracolumbar interfascial plane block provides effective perioperative pain relief for patients undergoing lumbar spinal surgery; a prospective, randomized and double blinded trial.
STUDY OBJECTIVE
Background: Although bilateral ultrasound-guided thoracolumbar interfascial plane (TLIP) block provides effective analgesia to the lumbar spinal region, a few previous studies for the TLIP block have only been reported up to the present. We aimed to study whether the TLIP block in combination with general anesthesia would provide more effective pain relief compared to general anesthesia alone.


DESIGN
Prospective randomized controlled trial.


SETTING
Operation and recovery room, hospital ward.


PATIENTS
Seventy-two patients undergoing primary lumbar laminoplasty of less than three levels between May 2016 and April 2017.


INTERVENTIONS
Seventy-two patients undergoing primary lumbar laminoplasty of less than three levels were randomly allocated to receive either the TLIP block combined with general anesthesia (T group, n = 35) or general anesthesia alone (C group, n = 34).


MEASUREMENT
The primary outcome measured the cumulative amount of fentanyl delivered to the patients through PCA within 48 h after the end of surgery. Secondary outcomes measured the number of delivered and requested PCA doses and VAS pain scores at the surgical site obtained at rest as well as with movement at specific time points within 48 h after the surgery.


MAIN RESULTS
During the first 48 h after surgery, the cumulative amount of delivered fentanyl (mean [standard deviation]) (μg) was lower in the T group (198.3 [103.1]) (μg) than in the C group (452.9 [175.4]) (μg) (P < 0.001). The number of delivered and requested PCA doses and the VAS pain scores was also lower in the T group than in the C group at all time points (all data were less than P < 0.05).


CONCLUSIONS
Bilateral TLIP block combined with general anesthesia provides more effective perioperative pain relief than that provided by general anesthesia alone in patients who undergo lumbar spinal surgery.
['Ueshima|Hironobu|H|', 'Hara|Eiko|E|', 'Otake|Hiroshi|H|']
D000368:Aged D000701:Analgesics, Opioid D000768:Anesthesia, General D004311:Double-Blind Method D005260:Female D005283:Fentanyl D006801:Humans D065406:Laminoplasty D008159:Lumbar Vertebrae D008297:Male D008875:Middle Aged D009407:Nerve Block D010149:Pain, Postoperative D011446:Prospective Studies D016896:Treatment Outcome D018084:Ultrasonography, Interventional
Lumbar spine Peripheral nerve block Postoperative analgesia