Intertransverse process and modified thoracolumbar interfascial plane blocks compared with conventional analgesia in lumbar disc herniation surgery: a randomized controlled trial.
Intertransverse process block lowered 24-hour morphine use most versus conventional analgesia.
Intertransverse process and modified thoracolumbar interfascial plane blocks compared with conventional analgesia in lumbar disc herniation surgery: a randomized controlled trial.
Lumbar disc herniation surgery is associated with considerable postoperative pain despite its minimally invasive nature.
This study compared the analgesic efficacy of ultrasound-guided intertransverse process (intertransverse process) and modified thoracolumbar interfascial plane (mTLIP) blocks with conventional analgesia in patients undergoing lumbar disc herniation surgery.
In this prospective randomized controlled trial, 84 patients undergoing elective lumbar disc herniation surgery under general anesthesia were allocated to a Control group, an mTLIP group, or an intertransverse process group (n = 28 each).
morphine use with an intertransverse process block, lowest of the three groups
Intraoperative remifentanil consumption was significantly lower in the intertransverse process and mTLIP groups than in the Control group (p < 0.001 and p = 0.001, respectively).
Resting pain scores were significantly lower in the intertransverse process group than in the Control group throughout the postoperative period, while dynamic pain scores were lower at the PACU time point and at 6, 12, and 24 h.
No significant differences in pain scores were observed between the mTLIP and Control groups or between the two block groups.
Both intertransverse process and mTLIP blocks reduced perioperative opioid requirements after lumbar disc herniation surgery, with no significant difference between the two blocks.
Compared with conventional analgesia, the intertransverse process block was additionally associated with lower postoperative pain scores and improved recovery quality.
Both techniques appear to be safe, comparably effective, opioid-sparing components of multimodal analgesia.