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Postoperative recovery scores and pain management: a comparison of modified thoracolumbar interfascial plane block and quadratus lumborum block for lumbar disc herniation

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Abstract

Purpose

In this prospective, randomized study, we aimed to compare the global recovery scores and postoperative pain management between US-guided mTLIP block versus QLB after lumbar spine surgery.

Methods

60 patients with ASA score I-II planned for microendoscopic discectomy under general anesthesia were included. We allocated the patients into two groups: the QLB group (n = 30) or the mTLIP group (n = 30). QLB and mTLIP was performed with 30 ml 0.25% bupivacaine in the groups. Paracetamol 1 g IV 3 × 1 was ordered to the patients at the postoperative period. If the NRS score was ≥ 4, 1 mg/kg tramadol IV was administered as rescue analgesia.

Results

There was a significant between-group difference in the mean global QoR-40 scores 24 h postsurgery. Both the static and dynamic NRS scores were significantly lower in the postoperative 1–16 h period in the mTLIP group. There was no significant between-group difference in the NRS scores 24 h postsurgery. There was no significant between-group difference in postoperative rescue analgesia consumption. However, the need for rescue analgesia was lower in the postoperative first 5 h in the mTLIP group, and survival probability was higher in the mTLIP group according to Kaplan–Meier survival analysis. There was no significant difference between the groups in the rate of adverse events.

Conclusion

mTLIP provided superior analgesia compared to posterior QLB. The QoR-40 scores in the mTLIP group were higher than those in the QLB group.

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Data availability

The datasets of the study are available from the corresponding author on reasonable request.

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Acknowledgements

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Funding

The authors have no sources of funding to declare for this manuscript.

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Authors and Affiliations

  1. Department of Anesthesiology and Reanimation, Istanbul Medipol University, Bagcilar, 34040, Istanbul, Turkey

    Selcuk Alver, Bahadir Ciftci & Cem Erdogan

  2. Department of Anesthesiology and Reanimation, Development and Design Application and Research Center, Ataturk University School of Medicine, Erzurum, Turkey

    Erkan Cem Celik & Ali Ahiskalioglu

  3. Istanbul Medipol University, Istanbul, Turkey

    Maral Sargolzaeimoghaddam

  4. Department of Neurosurgery, Istanbul Medipol University, Istanbul, Turkey

    Ahmet Cetinkal

Authors
  1. Selcuk Alver
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  2. Bahadir Ciftci
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  6. Cem Erdogan
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Contributions

All of the authors (SA, BC, ECC, MS, AC, CE, AA) made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; they have been involved in drafting the manuscript or revising it critically for important intellectual content; have given final approval of the version to be published.

Corresponding author

Correspondence to Bahadir Ciftci.

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Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

This study has been approved by Istanbul Medipol University Ethics and Research Committee. (06.01.2022, Decision No. 37) The study was registered and recorded on ClinicalTrials.gov (NCT05217121).

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Alver, S., Ciftci, B., Celik, E.C. et al. Postoperative recovery scores and pain management: a comparison of modified thoracolumbar interfascial plane block and quadratus lumborum block for lumbar disc herniation. Eur Spine J 33, 118–125 (2024). https://doi.org/10.1007/s00586-023-07812-3

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  • DOI: https://doi.org/10.1007/s00586-023-07812-3

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