A comparison of the ultrasound-guided modified-thoracolumbar interfascial plane block and wound infiltration for postoperative pain management in lumbar spinal surgery patients


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EKINCI M., ÇİFTÇİ B., ÇELIK E. C., YAYIK A. M., TAHTA A., ATALAY Y. O.

Agri, cilt.32, sa.3, ss.140-146, 2020 (ESCI) identifier identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 32 Sayı: 3
  • Basım Tarihi: 2020
  • Doi Numarası: 10.14744/agri.2019.97759
  • Dergi Adı: Agri
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, EMBASE, MEDLINE, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.140-146
  • Anahtar Kelimeler: Lumbar spinal surgery, modified thoracolumbar interfascial plane block, postoperative analgesia, wound infiltration
  • İstanbul Medipol Üniversitesi Adresli: Evet

Özet

Objectives: Pain management is an important issue following lumbar spinal surgery. Wound infiltration is a technique that a local anesthetic solution is infiltrated into the tissues around the surgical area. Previous studies reported that US-guided modified thoracolumbar interfacial plane (mTLIP) block after lumbar spinal surgery provided effective analgesia. In this study, we aimed to compare the analgesic efficacy of the US-guided mTLIP block and wound infiltration following lumbar disc surgery. Methods: 60 patients aged 18-65 years, ASA classification I-II, and scheduled for lumbar disc surgery under general anesthesia were included in the study. US-guided mTLIP block was performed via the lateral approach in group T (n=30), and wound infiltration was performed in group W (n=30). Opioid consumption, postoperative pain scores and adverse effects of opioids, such as allergic reactions, nausea, and vomiting, were recorded. Results: Opioid consumption and the use of rescue analgesia were significantly lower in group T in all the postoperative periods (1, 2, 4, 8, 16, and 24 h) (p<0.05). The VAS scores for pain during mobility and while at rest were significantly lower in group T than those in group W 8 h after the surgery (p<0.05). The incidences of nausea, vomiting, and itching in group W were higher than the incidences in group T. Conclusion: The mTLIP block provides effective analgesia for the first 24 h following lumbar disc surgery, and it may be an alternative to wound infiltration for pain management.