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

El-Taher, Ezzat M; Nasr, Nihal; Abuelnaga, Mohamed E; Elgawish, Yassmin

doi:10.2147/jpr.s329158

Cited by 14 publications

(12 citation statements)

References 39 publications

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“… 20 It puts forward a series of optimization measures to reduce postoperative complications and accelerate the speed of recovery and rehabilitation. 20 Eltaher et al 21 found that TLIP combined with general anesthesia can make the hemodynamics of patients more stable during operation, achieve good postoperative pain control, and reduce potential postoperative complications. Therefore, ultrasound-guided TLIP is an important part of modern spinal surgery, but data about nerve blocks for Tianji robot-assisted lumbar internal fixation is very scarce.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Modified Thoracolumbar Fascial Plane Block in Tianji Robot-Assisted Lumbar Internal Fixation: A Prospective, Randomized, and Non-Inferiority Study

Hu¹,

Shen²,

Pei³

et al. 2023

JPR

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Purpose Ultrasound-guided modified thoracolumbar fascial plane block (MTLIP) has been reported effective for postoperative pain control following lumbar surgery. Although trauma of the Tianji robot-assisted lumbar internal fixation is reduced, the degree of pain cannot be ignored.MTLIP may improve operation efficiency and reduce puncture complications.This study aimed to explore whether MTLIP is not inferior to thoracolumbar fascial plane block (TLIP) in the treatment of lumbar internal fixation. Methods This prospective double-blinded, non-inferiority randomized trial enrolled patients underwent Tianji robot-assisted lumbar internal fixation between April and August 2022 to either MTLIP or TLIP. The primary outcome was an effective dermatomal block area after 30 min. Secondary outcomes included the numeric rating scale (NRS) scores, nerve block operation time, puncture times, image clarity, patient satisfaction, intraoperative opioid consumption, complications/adverse reactions, and Oswestry Disability Index (ODI). Results Sixty participants were randomized to MTLIP (n=30) and TLIP (n=30). The effective dermatomal block area 30 min after block was non-inferior in the MTLIP group (283.6 ± 62.6 cm 2 ) compared with the TLIP group (261.4±53.2 cm 2 ) ( P =0.145; estimated mean difference: −22.17, 95% CI: −52.19, 7.85; smaller than the non-inferiority margin of 39.5). Compared with TLIP, MTLIP showed shorter operation time, smaller puncture times, and better target definition and satisfaction scores (all P <0.001). Sufentanil amount, remifentanil amount, PCIA sufentanil dosage, parecoxib amount, NRS scores (increased with time in the two groups but without inter-group differences), and complications were not significantly different between the two groups (all P >0.05). Conclusion This non-inferiority trial supports the hypothesis that MTLIP yields a non-inferior effective dermatomal block area compared with TLIP for Tianji robot-assisted lumbar internal fixation. Clinical Trials Registration Chinese Clinical Trial Registry (ChiCTR2200058687);.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Modified Thoracolumbar Fascial Plane Block in Tianji Robot-Assisted Lumbar Internal Fixation: A Prospective, Randomized, and Non-Inferiority Study

Hu¹,

Shen²,

Pei³

et al. 2023

JPR

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“…Evidence from several small single-center RCTs has mostly reported favorable results for TLIP blocks. 67,68 Two recent meta-analyses of available RCTs reported improved postoperative pain scores and reduced opioid use with TLIP blocks as compared with no block and wound infiltration alone in lumbar spine surgery; 69,70 however, the inclusion in the meta-analyses of now-retracted studies by Ueshima render the validity of these findings difficult to establish. Based on early evidence from three small single-center RCTs, it remains uncertain whether TLIP blocks provide comparable analgesia to ESP blocks for spine surgery.…”

Section: Thoracolumbar Interfascial Plane Blockmentioning

confidence: 99%

“…The thoracolumbar interfascial plane (TLIP) block, which involves LA injection into the fascial plane between the multifidus and longissimus muscles in the lumbar region, was first proposed by Hand et al 66 as an analgesic block for lumbar spine surgery. Evidence from several small single-center RCTs has mostly reported favorable results for TLIP blocks 67,68 . Two recent meta-analyses of available RCTs reported improved postoperative pain scores and reduced opioid use with TLIP blocks as compared with no block and wound infiltration alone in lumbar spine surgery; 69,70 however, the inclusion in the meta-analyses of now-retracted studies by Ueshima render the validity of these findings difficult to establish.…”

Section: Application Of Regional Anesthesia Techniques In Neuroanesth...mentioning

confidence: 99%

Regional Anesthesia Techniques in Modern Neuroanesthesia Practice: A Narrative Review of the Clinical Evidence

Uejima²,

Bebawy

2023

Journal of Neurosurgical Anesthesiology

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Neurosurgical procedures are often associated with significant postoperative pain that is both underrecognized and undertreated. Given the potentially undesirable side effects associated with general anesthesia and with various pharmacological analgesic regimens, regional anesthetic techniques have gained in popularity as alternatives for providing both anesthesia and analgesia for the neurosurgical patient. The aim of this narrative review is to present an overview of the regional techniques that have been incorporated and continue to be incorporated into modern neuroanesthesia practice, presenting in a comprehensive way the evidence, where available, in support of such practice for the neurosurgical patient.

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“…A lumbar plexus block might still be considered in hip revision surgery and in patients where high postoperative pain level is anticipated. 5 Femoral nerve blocks and fascia iliaca compartment blocks are frequently used for pain treatment after hip-fracture surgery and arthroplasty. 6 7 Compared with a lumbar plexus block, analgesia or anaesthesia will be less complete with these distal block techniques.…”

Section: Sp58 Blocks For Hip Surgery: Current Evidence and Future Per...mentioning

confidence: 99%

SP57 RA techniques in spine surgery: targeting a decrease in the use of morphine derivates

Roqués

2022

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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

Cited by 14 publications

References 39 publications

Ultrasound-Guided Modified Thoracolumbar Fascial Plane Block in Tianji Robot-Assisted Lumbar Internal Fixation: A Prospective, Randomized, and Non-Inferiority Study

Ultrasound-Guided Modified Thoracolumbar Fascial Plane Block in Tianji Robot-Assisted Lumbar Internal Fixation: A Prospective, Randomized, and Non-Inferiority Study

Regional Anesthesia Techniques in Modern Neuroanesthesia Practice: A Narrative Review of the Clinical Evidence

SP57 RA techniques in spine surgery: targeting a decrease in the use of morphine derivates

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