Optimizing postoperative pain in lumbar spine surgery: A prospective evaluation of tlip block versus local anaesthetic infiltration

Abstract

This prospective, randomized controlled trial sought to evaluate the pain-relieving effects of the Thoracolumbar Interfascial Plane (TLIP) block compared to local anesthetic infiltration in a group of 100 patients undergoing elective lumbar spine surgery. Participants aged between 18 and 50 years were assigned into two distinct groups: one group received an ultrasound-guided TLIP block utilizing 40 ml of 0.375% ropivacaine combined with 4 mg of dexamethasone, while the control group received the same solution via local infiltration at the surgical incision site. The main endpoint of this study was the time until the first analgesic was essential, whereas secondary endpoints involved total tramadol administration, hemodynamic stability, and assessments of pain and comfort scores. The TLIP group exhibited a significantly extended period to the primary analgesic requirement (9.8 minutes compared to 8.69 minutes, p = 0.00027) and a reduction in tramadol consumption (108.38 mg versus 122.20 mg, p = 0.044). The occurrence of postoperative nausea and vomiting was significantly reduced in the TLIP group. Hemodynamic stability remained more effectively preserved within the TLIP group, as evidenced by significant reductions in both blood pressure and heart rate following induction (p