Comparative Evaluation of Post-operative analgesic efficacy of Ultrasound-guided Modified Thoraco lumbar interfascial plane (mTLIP) block with Mid -transverse process to pleura (MTP) block in patients undergoing lumbar spine surgeries : A Prospective Randomised Observer Blinded Trial
Overview
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- SGPGIMS
- Enrollment
- 74
- Locations
- 1
- Primary Endpoint
- Total fentanyl consumption in 48 hours by use of IV Patient Controlled
Overview
Brief Summary
Approximately 50% of lumbar spine surgery patients experience severe post-operative pain. Pain can
lead to various complications such as prolonged immobilization and the need for prolonged opioid use.Various modalities
can be used for post-operative pain management like opioids, epidural and various blocks.None of the studies compared
mTLIP block with MTP block in lumbar spine surgeries to the best of our knowledge.Therefore we wish to compare the post
op analgesic efficacy of mTLIP block and MTP block. Our aim comparison of the post operative analgesic efficacy of
ultrasound guided Modified Thoraco lumbar interfascial plane (mTLIP) block with Mid -transverse process to pleura (MTP)
block who are undergoing lumbar spinal surgery under general anesthesia (GA). Our primary objective total fentanyl
consumption in 48 hours by use of IV Patient Controlled Analgesia. Secondary Objectives are Static and Dynamic Pain
assessment by Mean NRS (Numeric Rating Scale), Patient satisfactory score, Post operative nausea and vomiting, Block
Procedure Time, Total rescue analgesia used in 48 hours In our study patients will be randomly divided into two groupsmTLIP and MTP group Standard ASA monitors will be attached and GA will be given.Ventilator settings will be adjusted to
maintain ETCO2 33-36mmHg.Subject will be positioned prone Group mTLIP - a curvilinear low frequency probe is placed in
the transverse orientation at the midline at the level of the iliac crest and is moved laterally until the longissimus and
iliocostalis muscles and in the plane between these two muscle 20mL of 0.2% ropivacaine will be injected Group MTPlinear US probe to be placed in the parasagittal position 3 cm away from midline, needle will be advanced to the mid-point
between the transverse process and the pleura and 20mL of 0.2% ropivacaine will be injected.Block will be placed
bilaterally.Total amount of fentanyl consumption will be observed.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Masking
- Outcome Assessor Blinded
Eligibility Criteria
- Ages
- 18.00 Year(s) to 80.00 Year(s) (—)
- Sex
- All
Inclusion Criteria
- •1.Patient who had given written informed consent
- •Patients belonging to ASA grade I and II.
Exclusion Criteria
- •1.Patients who has refused to undergo this study.
- •2.ASA grade III and IV 3.Pregnant females 4.Patient who are allergic to local anesthetics 5.Patients with abnormal coagulation profile 6.Patients who have active skin infection at injection site 7.Patients with neuromuscular disorder
- •Patients with pre-existing autoimmune diseases 9.Patient with cognitive impairment, delirium and dementia.
Outcomes
Primary Outcomes
Total fentanyl consumption in 48 hours by use of IV Patient Controlled
Time Frame: 48 hours
Analgesia.
Time Frame: 48 hours
Secondary Outcomes
- 1.Static & Dynamic Pain assessment by Mean NRS (Numeric Rating Scale)(2.Patient satisfactory score)
Investigators
Dr Rafat Shamim
Sanjay Gandhi Post graduate institute of medical science