• Hironobu Ueshima, Eiko Hara, and Hiroshi Otake.
• Department of Anesthesiology, Showa University Hospital, Tokyo, Japan. Electronic address: ueshimhi@yahoo.co.jp.
• J Clin Anesth. 2019 Dec 1; 58: 12-17.

Study ObjectiveBackground: Although bilateral ultrasound-guided thoracolumbar interfascial plane (TLIP) block provides effective analgesia to the lumbar spinal region, a few previous studies for the TLIP block have only been reported up to the present. We aimed to study whether the TLIP block in combination with general anesthesia would provide more effective pain relief compared to general anesthesia alone.DesignProspective randomized controlled trial.SettingOperation and recovery room, hospital ward.PatientsSeventy-two patients undergoing primary lumbar laminoplasty of less than three levels between May 2016 and April 2017.InterventionsSeventy-two patients undergoing primary lumbar laminoplasty of less than three levels were randomly allocated to receive either the TLIP block combined with general anesthesia (T group, n = 35) or general anesthesia alone (C group, n = 34).MeasurementThe primary outcome measured the cumulative amount of fentanyl delivered to the patients through PCA within 48 h after the end of surgery. Secondary outcomes measured the number of delivered and requested PCA doses and VAS pain scores at the surgical site obtained at rest as well as with movement at specific time points within 48 h after the surgery.Main ResultsDuring the first 48 h after surgery, the cumulative amount of delivered fentanyl (mean [standard deviation]) (μg) was lower in the T group (198.3 [103.1]) (μg) than in the C group (452.9 [175.4]) (μg) (P < 0.001). The number of delivered and requested PCA doses and the VAS pain scores was also lower in the T group than in the C group at all time points (all data were less than P < 0.05).ConclusionsBilateral TLIP block combined with general anesthesia provides more effective perioperative pain relief than that provided by general anesthesia alone in patients who undergo lumbar spinal surgery.Copyright © 2019 Elsevier Inc. All rights reserved.

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