The analgesic efficacy of the transversalis fascia plane block in iliac crest bone graft harvesting: a randomized controlled trial
Background Iliac crest bone graft (ICBG) harvesting is associated with significant perioperative pain and opioid consumption. This randomized controlled trial sought to determine if the transversalis fascia plane (TFP) block provides effective analgesia for anterior ICBG harvesting. Methods Fifty pa...
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2019-08-01
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| Series: | Korean Journal of Anesthesiology |
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| Online Access: | http://ekja.org/upload/pdf/kja-d-18-00352.pdf |
| _version_ | 1819113006725857280 |
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| author | Nicholas D. Black Laith Malhas Rongyu Jin Anuj Bhatia Vincent W. S. Chan Ki Jinn Chin |
| author_facet | Nicholas D. Black Laith Malhas Rongyu Jin Anuj Bhatia Vincent W. S. Chan Ki Jinn Chin |
| author_sort | Nicholas D. Black |
| collection | DOAJ |
| description | Background Iliac crest bone graft (ICBG) harvesting is associated with significant perioperative pain and opioid consumption. This randomized controlled trial sought to determine if the transversalis fascia plane (TFP) block provides effective analgesia for anterior ICBG harvesting. Methods Fifty patients undergoing wrist fusion surgery with anterior ICBG harvesting were randomized to receive a TFP block with either 20 ml of 0.5% ropivacaine or 5% dextrose. Patients additionally received a brachial plexus block for primary surgical-site anesthesia and either a general or spinal anesthetic depending on patient preference. Primary outcomes of interest were perioperative opioid consumption (measured as intravenous morphine equivalents [IME]), pain intensity at the ICBG harvest site for up to 48 h postoperatively, and the incidence of persistent postoperative pain at 6 and 12 months after surgery. Results The TFP group used less opioid in the post-anesthetic care unit (PACU) (median 0 vs. 2.5 mg IME, P = 0.01) and in the first 8 h following PACU discharge (median 2.5 vs. 13.0 mg IME, P = 0.02). The patients who received a TFP block also had lower pain scores in PACU (median 0 vs. 4.0 out of 10, P < 0.001). Although opioid consumption and pain scores were lower in the TFP group at later timepoints, this difference was not statistically significant. Persistent pain at the ICBG site was reported in only 4.3% and 6.5% of all patients at 6 and 12 months, respectively. Conclusions The TFP block provides effective early analgesia for anterior ICBG harvesting. The incidence of persistent postoperative pain was low. |
| first_indexed | 2024-12-22T04:22:33Z |
| format | Article |
| id | doaj.art-8e87e187909f4cb4853bc740a9577a1a |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-12-22T04:22:33Z |
| publishDate | 2019-08-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-8e87e187909f4cb4853bc740a9577a1a2022-12-21T18:39:14ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632019-08-0172433634310.4097/kja.d.18.003528520The analgesic efficacy of the transversalis fascia plane block in iliac crest bone graft harvesting: a randomized controlled trialNicholas D. Black0Laith Malhas1Rongyu Jin2Anuj Bhatia3Vincent W. S. Chan4Ki Jinn Chin5 Department of Anesthesia, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada Department of Anesthesia, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK Department of Anesthesia, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada Department of Anesthesia, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada Department of Anesthesia, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada Department of Anesthesia, Toronto Western Hospital, University of Toronto, Toronto, ON, CanadaBackground Iliac crest bone graft (ICBG) harvesting is associated with significant perioperative pain and opioid consumption. This randomized controlled trial sought to determine if the transversalis fascia plane (TFP) block provides effective analgesia for anterior ICBG harvesting. Methods Fifty patients undergoing wrist fusion surgery with anterior ICBG harvesting were randomized to receive a TFP block with either 20 ml of 0.5% ropivacaine or 5% dextrose. Patients additionally received a brachial plexus block for primary surgical-site anesthesia and either a general or spinal anesthetic depending on patient preference. Primary outcomes of interest were perioperative opioid consumption (measured as intravenous morphine equivalents [IME]), pain intensity at the ICBG harvest site for up to 48 h postoperatively, and the incidence of persistent postoperative pain at 6 and 12 months after surgery. Results The TFP group used less opioid in the post-anesthetic care unit (PACU) (median 0 vs. 2.5 mg IME, P = 0.01) and in the first 8 h following PACU discharge (median 2.5 vs. 13.0 mg IME, P = 0.02). The patients who received a TFP block also had lower pain scores in PACU (median 0 vs. 4.0 out of 10, P < 0.001). Although opioid consumption and pain scores were lower in the TFP group at later timepoints, this difference was not statistically significant. Persistent pain at the ICBG site was reported in only 4.3% and 6.5% of all patients at 6 and 12 months, respectively. Conclusions The TFP block provides effective early analgesia for anterior ICBG harvesting. The incidence of persistent postoperative pain was low.http://ekja.org/upload/pdf/kja-d-18-00352.pdfanesthesiaconductionfascialocal anesthesianerve block |
| spellingShingle | Nicholas D. Black Laith Malhas Rongyu Jin Anuj Bhatia Vincent W. S. Chan Ki Jinn Chin The analgesic efficacy of the transversalis fascia plane block in iliac crest bone graft harvesting: a randomized controlled trial Korean Journal of Anesthesiology anesthesia conduction fascia local anesthesia nerve block |
| title | The analgesic efficacy of the transversalis fascia plane block in iliac crest bone graft harvesting: a randomized controlled trial |
| title_full | The analgesic efficacy of the transversalis fascia plane block in iliac crest bone graft harvesting: a randomized controlled trial |
| title_fullStr | The analgesic efficacy of the transversalis fascia plane block in iliac crest bone graft harvesting: a randomized controlled trial |
| title_full_unstemmed | The analgesic efficacy of the transversalis fascia plane block in iliac crest bone graft harvesting: a randomized controlled trial |
| title_short | The analgesic efficacy of the transversalis fascia plane block in iliac crest bone graft harvesting: a randomized controlled trial |
| title_sort | analgesic efficacy of the transversalis fascia plane block in iliac crest bone graft harvesting a randomized controlled trial |
| topic | anesthesia conduction fascia local anesthesia nerve block |
| url | http://ekja.org/upload/pdf/kja-d-18-00352.pdf |
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