Ultrasound-guided erector spinae plane block versus modified thoracolumbar interfascial plane block in lumbar spine surgeries: A randomized controlled trial

Abstract

Background: Lumbar spine surgery is often associated with intense postoperative pain. We compared ultrasound guided erector spinae plane block (ESPB) and modified thoracolumbar interfascial plane block (mTLIP) in patients undergoing lumbar spine surgeries under general anesthesia. The primary outcome was total postoperative fentanyl requirements. The secondary outcomes included pain score at rest and during movement, time of first postoperative analgesic request, and opioid side effects. Methods: One hundred eighty patients scheduled for spine surgeries under general anesthesia were enrolled in this randomized trial. They were randomized to receive ESPB, mTLIP, or not receive any block (control group). Blocks were done by injecting 20 mL of 0.5% ropivacaine mixed with 2 mcg/ml adrenaline. Results: Postoperative fentanyl (mcg) was significantly higher in the group C in comparison with the ESPB and the mTLIP groups P < 0.001; however, it was comparable between the ESPB and the mTLIP groups ( P = 0.08). Also, Numerical Rating Scale (NRS) scores either during rest or during movement was higher in the early postoperative hours in the group C; however, both the block groups provide comparable NRS scores either during rest or during movement with P > 0.05 at all time intervals during the first 24 h. Conclusion: Both ultrasound guided ESPB and mTLIP decrease the perioperative amount of fentanyl consumption and provide comparable pain scores at rest and during movement during the first postoperative 24 h in lumbar spine surgeries