A prospective and randomized trial comparing modified and classical techniques of ultrasound-guided thoracolumbar interfascial plane block

Abstract

Objectives: A thoracolumbar interfascial plane (TLIP) block is a novel ultrasound (US)-guided technique that provides effective analgesia after lumbar spinal surgery. Two approaches for a TLIP block have been defined: A classical (cTLIP) technique and a modified (mTLIP) technique. A literature review revealed no published comparison of the 2 techniques. This study examined the practicality and analgesic efficacy of US-guided mTLIP and cTLIP blocks following lumbar disc surgery. Methods: Sixty patients aged 18-65 years with an American Society of Anesthesiologists classification of I or II who were scheduled for lumbar disc surgery under general anesthesia were included. US-guided mTLIP (n=30) and cTLIP (n=30) blocks were performed. The performance time of the block procedures, the success of a one-time block, postoperative pain scores, opioid consumption, adverse effects, and block-related complications were recorded and analyzed. Results: The performance time was significantly less in the mTLIP group (p<0.001). The success of a one-time block was significantly higher in the mTLIP group (p<0.001). The active/passive visual analog scale scores, intraoperative and postoperative opioid consumption, and rescue analgesic requirements were similar between the groups (p>0.05). Conclusion: The results showed that a US-guided mTLIP block had a shorter performance time and a higher one-time block success rate compared with the cTLIP block. The quality of analgesia provided by the mTLIP and cTLIP blocks was similar.