Coquet A, Sion A, Bourgoin A, Ropars M, Beloeil H. Transversus Abdominis Plane Block for Anterior Lumbar Interbody Fusion: a randomized controlled trial.
Spine J 2023:S1529-9430(23)00151-1. [PMID:
37031893 DOI:
10.1016/j.spinee.2023.03.013]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/07/2023] [Accepted: 03/22/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND CONTEXT
ALIF (Anterior Lumbar Interbody Fusion) is a lumbar arthrodesis technique via an anterior approach that is less invasive than the posterior approaches. However, it is associated with specific pain in the abdominal wall.
PURPOSE
The objective of this study was to determine whether performing a bilateral ultrasound-guided TAP (Transversus Abdominis Plane) block allows a reduction in morphine consumption in the first 24 hours after surgery.
STUDY DESIGN
This study is a prospective single-centre, randomized, double-blind study.
PATIENT SAMPLE
Patients undergoing ALIF surgery were included and randomized into two groups. Both groups received a TAP block performed at the end of surgery with either ropivacaine or placebo.
OUTCOME MEASURES
The primary outcome measure was morphine consumption in the first 24 hours. The main secondary outcomes were immediate postoperative pain and opioid-related side effects METHODS: Intra- and postoperative anaesthesia and analgesia protocols where standardized. A bilateral ultrasound-guided TAP block was performed with 75 mg (in 15 ml) of ropivacaine per side or isotonic saline serum depending on their assignment group.
RESULTS
Forty-two patients were included in the study (21 per group). Morphine consumption at 24 hours (28 mg [18 - 35] in the ropivacaine group vs 25 mg [19 - 37] in the placebo group (p=0.503)) were not significantly different between the 2 groups.
CONCLUSION
TAP block with ropivacaine or placebo provided a similar postoperative analgesia when associated with a multimodal analgesia protocol for ALIF.
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