Inter-semispinal plane (ISP) block for postoperative analgesia following cervical spine surgery: A prospective randomized controlled trial

Mostafa, Shaimaa F.; Elyazed, Mohamed M. Abu; Eid, Gehan M.; Belal, Aliaa Muhammad

doi:10.1016/j.jclinane.2022.110974

Cited by 10 publications

(9 citation statements)

References 12 publications

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“…The dorsal rami of the cervical spinal nerves from C4 to T4 were intended to be blocked by the ISP block, which also aimed to provide adequate postoperative analgesia . Mostafa 19 evaluated the analgesic effect of the ISP block in 60 participants and concluded that it effectively reduced pain and decreased analgesic consumption after posterior cervical surgery.…”

Section: Discussionmentioning

confidence: 99%

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The use of bilateral inter-semispinal plane block to effectively enhance the recovery pathway for posterior cervical surgery—A prospective randomized controlled study

Li,

Zhang,

Sun

et al. 2023

Preprint

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Background: Bilateral inter-semispinal plane (ISP) block can be used to alleviate postoperative pain in patients underwent posterior cervical surgery, this study aimed to determine if bilateral ISP block can promote recovery after surgery for patients undergoing posterior cervical surgery. Methods: 100 patients were assigned randomly to either the control or ISP block group. The main outcome was the length of stay (LOS). The secondary outcomes include the Numerical Rating Scale(NRS) scores, times of PCIA press, and total consumption of rescue analgesic drugs. The patient’s postoperative life quality was evaluated using a 40-item quality of recovery score (QoR-40), time to first walk independently and oral intake. We also recorded postoperative negative outcomes. Result: The mean LOS in the ISP group was significantly shorter than that in the control group (7.52 ±1.34 vs. 8.98 ±1.32 days, P = 0.014). Within 24 h postoperatively, pain scores in the ISP block group were lower than in the control group (P ＜ 0.001), however, the NRS scores at 48 h were not significantly different (P = 0.631). The PCIA press times and pentazocine consumption in the ISP group were significantly reduced compared with those in the control group (P ＜ 0.001). Postoperative total QoR-40 scores and its 4 dimensions were higher in the ISP group than in the control group (P < 0.001), except the independence. Oral intake and unassisted walking in the ISP group were shorter than those in the control group (P ＜ 0.001). Adverse effects were not different in neither group (P > 0.05). Conclusion: Bilateral ISP block could significantly and safely promote recovery for patients undergoing posterior cervical surgery. Trial registration: The trial was registered at the Chinese Clinical Trial Registry (www.chictr.org.cn) (No: ChiCTR2300069813); 27/03/2023

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Section: Discussionmentioning

confidence: 99%

“…Thus, it blocks the dorsal branch of the spinal nerve and provides su cient postoperative analgesia 18 . Furthermore, ISP block may help lessen postoperative discomfort and the requirement for analgesics postoperatively in patients undergoing posterior cervical surgery 19 .…”

Section: Introductionmentioning

confidence: 99%

The use of bilateral inter-semispinal plane block to effectively enhance the recovery pathway for posterior cervical surgery—A prospective randomized controlled study

Li,

Zhang,

Sun

et al. 2023

Preprint

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“…To account for possible withdrawals, we chose to recruit 25 patients in each group. We employed a two-sample independent, two-sided t -test to calculate the sample size, emphasizing our commitment to conducting precise research ( 9 ).…”

Section: Methodsmentioning

confidence: 99%

Inter-Semispinalis Plane Block Versus General Anesthesia for Postoperative Analgesia in Posterior Cervical Spine Surgery: A Randomized Controlled Trial

Mahmoud,

Alsaied,

Ragab

et al. 2024

Anesth Pain Med

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Background: Postoperative pain management is crucial for improving patient outcomes following posterior cervical spine surgery. Opioids are effective but carry a risk of respiratory depression. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used but may not provide adequate pain relief and have potential complications. The inter-semispinalis plane (ISPB) block is a novel technique for postoperative analgesia in cervical spine surgery. Objectives: This study aims to evaluate and compare the efficacy of the ISPB with general anesthesia in terms of analgesia, postoperative Visual Analog Scale (VAS) pain scores, patient-surgeon satisfaction levels, and the occurrence of postoperative complications. Methods: This double-blind, randomized controlled trial was blinded to both the patient and the assessor. Fifty adult patients (18 - 60 years old) undergoing elective posterior cervical spine surgery were enrolled. The participants were divided into 2 groups: The ISPB group (receiving bilateral ultrasound-guided ISPB at the C5 level) and the control group (receiving general anesthesia only), with each group comprising 25 patients. The study assessed intraoperative fentanyl use, postoperative VAS pain levels, the need for rescue analgesia, and complications. Results: The ISPB group showed significantly lower intraoperative fentanyl consumption (median 100 vs. 100 - 150 μg, P = 0.022) and lower postoperative pain scores at 1, 8, 12, and 48 hours (P = 0.016, 0.009, 0.005, 0.016). Additionally, the ISPB group required less postoperative pethidine (20% vs. 64%, P = 0.002) and had a longer delay before requesting pethidine (hazard ratio 0.215, P = 0.001). Surgeon satisfaction was significantly higher in the ISPB group (P = 0.003). These results suggest that the ISPB can effectively reduce pain and analgesic requirements. Conclusions: The ISPB is an effective analgesic technique for posterior cervical spine surgery, reducing opioid consumption, providing better pain control, and enhancing surgeon satisfaction without increasing complications. This approach has the potential to improve postoperative care and patient outcomes in this surgical population.

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“…In another study, Mostafa et al [56] randomized participants to receive either general anesthesia alone (the control group) or bilateral ultrasound-guided ISP blocks at the C5 level with 20 mL of bupivacaine 0.25% in each side with general anesthesia (the ISP group) for posterior cervical spine surgery. After 30 min, 1 h, 2 h, 4 h, 6 h, 8 h, and 12 h postoperatively, the VAS scores of patients in the ISP group were considerably lower than those of patients in the control group.…”

Section: Inter-semispinal Plane Block (Isp)mentioning

confidence: 99%

Ultrasound-Guided Blocks for Spine Surgery: Part 1—Cervix

Adamczyk

Koszela

Zaczyński

et al. 2023

IJERPH

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Postoperative pain is common following spine surgery, particularly complex procedures. The main anesthetic efforts are focused on applying multimodal analgesia beforehand, and regional anesthesia is a critical component of it. The purpose of this study is to examine the existing techniques for regional anesthesia in cervical spine surgery and to determine their effect and safety on pain reduction and postoperative patient's recovery. The electronic databases were searched for all literature pertaining to cervical nerve block procedures. The following peripheral, cervical nerve blocks were selected and described: paravertebral block, cervical plexus clock, paraspinal interfascial plane blocks such as multifidus cervicis, retrolaminar, inter-semispinal and interfacial, as well as erector spinae plane block and stellate ganglion block. Clinicians should choose more superficial techniques in the cervical region, as they have been shown to be comparably effective and less hazardous compared to paravertebral blocks

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Inter-semispinal plane (ISP) block for postoperative analgesia following cervical spine surgery: A prospective randomized controlled trial

Cited by 10 publications

References 12 publications

The use of bilateral inter-semispinal plane block to effectively enhance the recovery pathway for posterior cervical surgery—A prospective randomized controlled study

The use of bilateral inter-semispinal plane block to effectively enhance the recovery pathway for posterior cervical surgery—A prospective randomized controlled study

Inter-Semispinalis Plane Block Versus General Anesthesia for Postoperative Analgesia in Posterior Cervical Spine Surgery: A Randomized Controlled Trial

Ultrasound-Guided Blocks for Spine Surgery: Part 1—Cervix

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