الفهرس 
Analgesic efficacy of two different volumes of local anesthetics in ultrasound-guided modified approach to the thoracolumbar interfacial plane block in patients undergoing lumbar spine surgeries; a randomized controlled trial
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Abstract
There is a lack of clarity regarding the optimal dose, ideal local
anesthetic volume, and concentration for mTLIP block. This study was designed
to investigate the analgesic efficacy of two different volumes of Bupivacaine
0.25% (20ml, and 10ml) for ultrasound-guided mTLIP block in patients
undergoing lumbar spine surgeries.
Method: This randomized controlled double-blinded study. Patients received
single shot of bilateral mTLIP block at the mid-level of the operative
intervention and were randomly allocated into one of the two groups to receive
either10 or 20 ml 0.25%bupivacaine on each side. Time to first rescue analgesia
was set as the primary outcome. Total morphine consumption in the first 24
hours postoperative and Numeric Pain Rating Scale at rest and during movement
were set as secondary outcomes.
Results: Time of first request of rescue morphine was significantly lower in 10
ml group (7.80 ± 3.98) compared to 20 ml group (13.23 ± 3.00) (P value
<0.001). On the other hand, there was no significant difference in the total dose
of postoperative morphine consumption over the first 24 hrs was higher in 10 ml
group (6.20 ± 2.18) compared to 20 ml group (5 ± 0.00) (P value =0.056). NRS
at rest and movement in all time measurements (30min, 2h, 4hr, 6hr, 8hr, 12hr,
16hr, 20hr and 24hr postoperative) was significantly higher in group (10ml)
compared to group (20ml).
Conclusion: The mTLIP block using 20 ml of 0.25 % bupivacaine increased the
postoperative total analgesic duration for lumbar spine surgeries, decreases total
morphine consumption in the first 24 hours postoperative and produces less
postoperative numerical rating scale compared to 10 ml of 0.25 % bupivacaine.
Clinical trial registration: The study was registered at clinicaltrials.gov (NCT
05276908)