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CC BY 4.0 · J Neuroanaesth Crit Care
DOI: 10.1055/s-0044-1782506
Original Article

Analgesic Efficacy of Thoracolumbar Interfascial Plane Block versus Standard Care in Patients Undergoing Lumbar Spinal Surgeries—A Randomized Controlled Trial

Suman Saini
1   Department of Anesthesiology and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India
,
Ananya Sharma
1   Department of Anesthesiology and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India
,
Anju Gupta 
2   Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
,
Dipankar S. Mankotia
3   Department of Neurosurgery, Vardhman Mahavir Medical College and Safdarjung Hospital (SJH), Delhi, India
,
Tankeswar Boruah
4   Central Institute of Orthopedics, Vardhman Mahavir Medical College and Safdarjung Hospital (SJH), Delhi, India
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Abstract

Background Patients who undergo spine surgery often experience severe pain postoperatively. Multimodal analgesia inclusive of a regional block provides optimal pain relief. Thoracolumbar interfascial plane (TLIP) block may provide promising analgesia in these patients.

Materials Fifty consenting adults aged between 18 and 60 years undergoing elective lumbar spinal surgeries under balanced general anesthesia were divided into two equal groups (group T: received bilateral TLIP block, and group C: received conventional opioid analgesia). All the patients were taken care of by an independent anesthesiologist unaware of the study protocol in the postanesthesia care unit. The postoperative pain was assessed by visual analog scale (VAS). Time to first rescue analgesia, total morphine consumption, complications, and patient satisfaction were also recorded.

Results Postoperative mean VAS scores till 12 hours were significantly higher in the control group. The mean time to the first analgesic requirement among group T and group C patients was 404.4 ± 25.1 and 150.2 ± 12.4 minutes, respectively (p < 0.001). Morphine consumptions in 24 hours were also significantly higher in group C (3.36 ± 1.04 vs. 7.84 ± 1.43; p < 0.001). Mean intraoperative fentanyl consumption was significantly more in group C (122.4 ± 16.4 µg and 140.4 ± 21.7 µg; p = 0.001). Complications were similar in both groups. However, patient satisfaction was significantly higher in group T (p < 0.001).

Conclusion TLIP block provided superior analgesia, decreased opioid consumption, and improved patient satisfaction as compared with patients receiving standard general anesthesia with opioid analgesics. Hence, TLIP block could be a component of multimodal analgesia in patients undergoing lumbar spine surgeries.

CTRI No.: CTRI/2021/03/031682

Keywords

analgesia - TLIP block - postoperative - spinal fusion - regional anesthesia


Publication History

Article published online:
02 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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