EFFICACY OF ULTRASOUND GUIDED THORACO LUMBAR INTERFASCIAL PLANE BLOCK VERSUS EPIDURAL ANALGESIA IN PAIN MANAGEMENT FOLLOWING LUMBAR DISC SURGERY

Abstract

Background: The thoracolumber interfascial plane (TLIP) block is a major regional
anaesthetic technique impacting the dorsal rami of the thoracolumbar nerves as they travel
through the paraspinal musculature rather than the ventral rami (analogous to the ventral rami
for the TAP block).
Patients and Methods: This prospective, randomized, double-blind, controlled study was
conducted in Minia University Hospital from 6- 2018 to 6- 2020, after permission by the
Minia University faculty of medical ethical committee (22/2018) and informed written
consent. The study participants ranged in age from 18 to 70 years old and had an ASA
physical status of I to II. They were planned to have lumbar discectomy or lamenectomy
procedures under general anesthesia.

Results: The median VAPS score at rest was notable decreased in TLIP group than control
group during 12 h postoperative, while in comparison with E group was significantly lower
from 4h to 12h. E group showed important decreased median VAPS than control group
during first 4h postoperative. Dynamic VAPS was notable lower in TLIP group in the first 12
h of the observing day in comparison to control group, while it was much lower than epidural
group from 4h to 12h. E group showed significantly lower median VAPS than control group
during the first 2h postoperative. TLIP group showed the lowest cumulative fentanyl
consumption (44.20±12.39) than epidural (114.00±23.8) and control groups (160.80±32.82).
Conclusion: In individuals undergoing lumbar discectomy, ultrasound guided thoracolumbar
interfascial plane block has been linked to lower opioid use and good pain scores when
matched to epidural anesthesia at closure. We believe that thoracolumbar interfascial plane
block is an useful replacement for postoperative analgesia after lumbar discectomy and should
be utilized as part of a balanced analgesia strategy