Modified Thoracolumbar Interfascial Plane Block Versus Erector Spinae Plane Block in Patients Undergoing Spine Surgeries: A Randomized Controlled Trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2024;12(13):38 J Neurosurg Anesthesiol . 2024 Apr 1;36(2):119-124.What this means for my practice?
Overall, the erector spinae plane (ESP) block is associated with lower postoperative opioid consumption and pain scores compared to the modified thoracolumbar interfascial plane (mTLIP) block in lumbar spine surgeries, making it a potentially more effective option for pain management. The key takeaway is that incorporating the ESP block into multimodal analgesic regimens could enhance postoperative pain relief and reduce opioid use. A limitation of the study is its small sample size and lack of a control group, which may impact the generalizability of the findings.
Study Summary
Sixty patients with lumbar spine conditions were randomized to receive either a modified thoracolumbar interfascial plane (mTLIP) block (n=30) or an erector spinae plane (ESP) block (n=30). The primary outcome of interest was 48-hour postoperative fentanyl consumption. Secondary outcomes included additional intraoperative fentanyl requirements, postoperative pain scores at rest at various time points (1, 2, 4, 6, 12, 24, and 48 hours), and incidence of nausea, vomiting, and excessive sedation. Outcomes were assessed up to 48 hours postoperatively. Overall, the results of the study revealed that the ESP block was associated with lower 48-hour postoperative fentanyl consumption and lower postoperative pain scores compared to the mTLIP block, particularly within the first 24 hours postoperatively. The findings suggest that the ESP block may be more effective for pain management in lumbar spine surgeries than the mTLIP block.
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