• Shaimaa F Mostafa, Mohamed M Abu Elyazed, Gehan M Eid, and Aliaa M Belal.
• Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt. Electronic address: shaimaafarouk7777@yahoo.com.
• J Clin Anesth. 2022 Dec 1; 83: 110974110974.

Study ObjectiveWe evaluated the perioperative analgesic effects of the inter-semispinal plane (ISP) block in patients undergoing posterior cervical spine surgery.DesignProspective, randomized, controlled, double-blinded trial.SettingOperating room and surgical ward.Patients60 patients aged 18-60 years of either gender, ASA I-II, undergoing elective posterior cervical spine surgery.InterventionsPatients were randomly assigned into a control group (general anesthesia only), ISP group received bilateral ultrasound guided ISP block at the level of C5 using 20 ml bupivacaine 0.25% on each side.MeasurementsVisual analog scale (VAS), intraoperative fentanyl and 24 h postoperative pethidine consumptions and time to first rescue analgesic request were documented.Main ResultsThe median (quartiles) of 24 h postoperative rescue pethidine consumption was significantly lower in the ISP group [0 (0-46.25) mg] compared to that of the control group [143 (116.75-169.00) mg]; P < 0.001). VAS was significantly lower in the ISP group at 30 min, 1 h, 2 h,4 h, 6 h, 8 h and 12 h postoperative compared to control group (P < 0.05). At 18 and 24 h, VAS was not significantly different between groups. The median (quartiles) of intraoperative fentanyl consumption in the ISP group [0 (0-40.75) μg] was significantly lower compared to that of the control group [63.5 (39.5-90.25) μg]; P < 0.001]. The time to first rescue analgesic administration was significantly longer in the ISP group compared to the control group (P < 0.001).ConclusionBilateral ultrasound-guided ISP block can provide decreased 24 h postoperative analgesic consumption as well as lower pain scores in the first 12 postoperative hours in patients undergoing posterior cervical spine surgery.Copyright © 2022 Elsevier Inc. All rights reserved.

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