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Postoperative quality of recovery with erector spinae plane block or thoracolumbar interfascial plane block after major spinal surgery: a randomized controlled trial

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Abstract

Purpose

Major spinal surgery causes severe postoperative pain. The present randomized, controlled, prospective study tested the short- and long-term effects of thoracolumbar interfascial and erector spinae plane blocks on patient-centered outcomes for major lumbar spinal surgery.

Methods

Sixty adult patients were randomly assigned to receive either bilateral thoracolumbar interfascial plane or erector spinae plane block after anesthesia induction using bupivacaine 0.25%, 20 mL. The primary outcome of this study was the Quality of Recovery-40 score in the postoperative 24th hour. Secondary outcomes were Comprehensive Complication Index scores, postoperative pain scores, opioid consumption, first rescue analgesic administration time, and complication incidence.

Results

The recovery scores of both blocks at the postoperative 24th hour were similar, with a median thoracolumbar interfascial plane block of 178 (IQR 173–180) and an erector spinae plane block of 175 (IQR 168.7–182) (p = 0.717). Thoracolumbar interfascial plane block reduced area under the curve pain with movement over 24 h compared with erector spinae plane block (p = 0.024). The pain scores between the groups were similar at all time points (p > 0.05), except the 24th hour with movement in the thoracolumbar interfascial plane block compared with the erector spinae plane block [median 3 (IQR 2–4)] vs. 4 (IQR 3–5), respectively] (p = 0.019). No differences were recorded between the block groups regarding postoperative 24th-h oxycodone consumption, time to first opioid intake, and complication incidence (p > 0.05).

Conclusions

Both blocks resulted in similar quality of recovery in the postoperative 24-h period in major spinal surgery and were effective in terms of analgesia.

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Acknowledgements

The authors thank all anesthetists and nurses for assisting with this clinical trial.

Funding

The authors report no involvement in the research by the sponsor that could have influenced the outcome of this work.

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Authors and Affiliations

  1. Department of Anesthesiology and Reanimation, Faculty of Medicine, Karamanoglu Mehmetbey University, Universite Mh. Sehit Omer Halis Demir Street, No:7, 70100, Karaman, Turkey

    Ayşegül Bilge & Betül Başaran

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Contributions

All of the authors (AB, BB) made substantial contributions to the conception and design, 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.

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Correspondence to Ayşegül Bilge.

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No potential conflict of interest relevant to this article was reported.

Ethical approval

This study has been approved by Karamanoglu Mehmetbey University Ethics and Research Committee. (03.08.2021, Decision No: 05-2021/13) The study was registered and recorded on ClinicalTrials.gov (NCT05023850).

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Bilge, A., Başaran, B. Postoperative quality of recovery with erector spinae plane block or thoracolumbar interfascial plane block after major spinal surgery: a randomized controlled trial. Eur Spine J 33, 68–76 (2024). https://doi.org/10.1007/s00586-023-07998-6

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  • DOI: https://doi.org/10.1007/s00586-023-07998-6

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