Effect of Ultrasound-Guided Thoracolumbar Interfascial Plane Block on the Analgesic Requirements in Patients Undergoing Lumbar Spine Surgery Under General Anesthesia: A Randomized Controlled Trial

Ezzat Eltaher, Nihal Nasr, Mohamed E Abuelnaga, Yassmin Elgawish Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Suez Canal University, Ismailia, EgyptCorrespondence: Mohamed E AbuelnagaDepartment of Anesthesia, Intensive Care and Pain Management, Faculty of Medici...

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Main Authors: Eltaher E, Nasr N, Abuelnaga ME, Elgawish Y
Format: Article
Language:English
Published: Dove Medical Press 2021-11-01
Series:Journal of Pain Research
Subjects:
Online Access:https://www.dovepress.com/effect-of-ultrasound-guided-thoracolumbar-interfascial-plane-block-on--peer-reviewed-fulltext-article-JPR
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author Eltaher E
Nasr N
Abuelnaga ME
Elgawish Y
author_facet Eltaher E
Nasr N
Abuelnaga ME
Elgawish Y
author_sort Eltaher E
collection DOAJ
description Ezzat Eltaher, Nihal Nasr, Mohamed E Abuelnaga, Yassmin Elgawish Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Suez Canal University, Ismailia, EgyptCorrespondence: Mohamed E AbuelnagaDepartment of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Suez Canal University, The Ring Road, P.O. Box 41522, Ismailia, EgyptTel +2001004150671Fax +20643208543Email Mohamed_abuelnga@med.suez.edu.egBackground: Thoracolumbar interfascial plane (TLIP) block was recently described as a regional anesthetic technique to achieve analgesia for lumbar spine surgery by blocking the dorsal rami of spinal nerves. The study aims to test the hypothesis that TLIP block can offer pain control and reduce the perioperative analgesic requirement in patients undergoing spinal surgery.Methods: There were 60 patients scheduled for lumbar spine surgery who were randomly assigned into two equal groups, TLIP and control groups. Patients in the TLIP group received general anesthesia and TLIP block while patients in the control group received general anesthesia alone. The primary outcome was the analgesic consumption in the first postoperative 24 hours, while intraoperative additional analgesic needs, time to the first request of postoperative analgesia, and pain scores were the secondary outcomes.Results: At 24 hours postoperatively, morphine consumption was lower in the TLIP group (5.13± 1.55) versus the control group (14.33± 2.58) mg. The intraoperative fentanyl consumption was lower in the TLIP group (15± 35.11 mcgs) versus the control group (105± 62.08 mcgs). Postoperative first request for analgesia was delayed in the TLIP group (7.30± 2.69 h) compared to the control group (0.92± 1.23 h). Postoperative Pain scores at rest were 2.53 ± 0.97 and 3.43 ± 0.50 at 24 hours in the TLIP group and the control group, respectively. Postoperative Pain scores at passive flexion of spine were 2.73 ± 0.87 and 3.93 ± 0.78 at 24 hours in the TLIP group and the control group, respectively. Patients in the TLIP group had lower perioperative hemodynamic responses to surgical stimulation in comparison to the control group.Conclusion: Combined TLIP block with general anesthesia in patients undergoing spinal surgery reduced both postoperative and intraoperative analgesic needs, reduced intra-operative hemodynamic response to surgery, and achieved good postoperative pain control.Keywords: TLIP block, postoperative pain, spine surgery
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spelling doaj.art-082a11c3880349508021bc4c7a4780fb2022-12-21T17:33:37ZengDove Medical PressJournal of Pain Research1178-70902021-11-01Volume 143465347470307Effect of Ultrasound-Guided Thoracolumbar Interfascial Plane Block on the Analgesic Requirements in Patients Undergoing Lumbar Spine Surgery Under General Anesthesia: A Randomized Controlled TrialEltaher ENasr NAbuelnaga MEElgawish YEzzat Eltaher, Nihal Nasr, Mohamed E Abuelnaga, Yassmin Elgawish Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Suez Canal University, Ismailia, EgyptCorrespondence: Mohamed E AbuelnagaDepartment of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Suez Canal University, The Ring Road, P.O. Box 41522, Ismailia, EgyptTel +2001004150671Fax +20643208543Email Mohamed_abuelnga@med.suez.edu.egBackground: Thoracolumbar interfascial plane (TLIP) block was recently described as a regional anesthetic technique to achieve analgesia for lumbar spine surgery by blocking the dorsal rami of spinal nerves. The study aims to test the hypothesis that TLIP block can offer pain control and reduce the perioperative analgesic requirement in patients undergoing spinal surgery.Methods: There were 60 patients scheduled for lumbar spine surgery who were randomly assigned into two equal groups, TLIP and control groups. Patients in the TLIP group received general anesthesia and TLIP block while patients in the control group received general anesthesia alone. The primary outcome was the analgesic consumption in the first postoperative 24 hours, while intraoperative additional analgesic needs, time to the first request of postoperative analgesia, and pain scores were the secondary outcomes.Results: At 24 hours postoperatively, morphine consumption was lower in the TLIP group (5.13± 1.55) versus the control group (14.33± 2.58) mg. The intraoperative fentanyl consumption was lower in the TLIP group (15± 35.11 mcgs) versus the control group (105± 62.08 mcgs). Postoperative first request for analgesia was delayed in the TLIP group (7.30± 2.69 h) compared to the control group (0.92± 1.23 h). Postoperative Pain scores at rest were 2.53 ± 0.97 and 3.43 ± 0.50 at 24 hours in the TLIP group and the control group, respectively. Postoperative Pain scores at passive flexion of spine were 2.73 ± 0.87 and 3.93 ± 0.78 at 24 hours in the TLIP group and the control group, respectively. Patients in the TLIP group had lower perioperative hemodynamic responses to surgical stimulation in comparison to the control group.Conclusion: Combined TLIP block with general anesthesia in patients undergoing spinal surgery reduced both postoperative and intraoperative analgesic needs, reduced intra-operative hemodynamic response to surgery, and achieved good postoperative pain control.Keywords: TLIP block, postoperative pain, spine surgeryhttps://www.dovepress.com/effect-of-ultrasound-guided-thoracolumbar-interfascial-plane-block-on--peer-reviewed-fulltext-article-JPRtlip blockpostoperative painspine surgery.
spellingShingle Eltaher E
Nasr N
Abuelnaga ME
Elgawish Y
Effect of Ultrasound-Guided Thoracolumbar Interfascial Plane Block on the Analgesic Requirements in Patients Undergoing Lumbar Spine Surgery Under General Anesthesia: A Randomized Controlled Trial
Journal of Pain Research
tlip block
postoperative pain
spine surgery.
title Effect of Ultrasound-Guided Thoracolumbar Interfascial Plane Block on the Analgesic Requirements in Patients Undergoing Lumbar Spine Surgery Under General Anesthesia: A Randomized Controlled Trial
title_full Effect of Ultrasound-Guided Thoracolumbar Interfascial Plane Block on the Analgesic Requirements in Patients Undergoing Lumbar Spine Surgery Under General Anesthesia: A Randomized Controlled Trial
title_fullStr Effect of Ultrasound-Guided Thoracolumbar Interfascial Plane Block on the Analgesic Requirements in Patients Undergoing Lumbar Spine Surgery Under General Anesthesia: A Randomized Controlled Trial
title_full_unstemmed Effect of Ultrasound-Guided Thoracolumbar Interfascial Plane Block on the Analgesic Requirements in Patients Undergoing Lumbar Spine Surgery Under General Anesthesia: A Randomized Controlled Trial
title_short Effect of Ultrasound-Guided Thoracolumbar Interfascial Plane Block on the Analgesic Requirements in Patients Undergoing Lumbar Spine Surgery Under General Anesthesia: A Randomized Controlled Trial
title_sort effect of ultrasound guided thoracolumbar interfascial plane block on the analgesic requirements in patients undergoing lumbar spine surgery under general anesthesia a randomized controlled trial
topic tlip block
postoperative pain
spine surgery.
url https://www.dovepress.com/effect-of-ultrasound-guided-thoracolumbar-interfascial-plane-block-on--peer-reviewed-fulltext-article-JPR
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