Low Back Pain Clinical Trial
Official title:
Comparison of Erector Spinae Plane (ESP) Block and Thoracolumbar Interfascial Plane(TLIP) Block for the Management of Postoperative Pain in Spinal Surgery
Lumbar vertebra surgery is one of the most common surgical procedures. After lumbar veretebra
surgery, patients complain of excessive pain. Postoperative pain usually occurs in the early
postoperative period and delays patient mobilization and thus lengthens hospital stay.
The aim of this study was to compare the efficacy of erector spina plan(ESP) block and
thoraco lumbar interfacial(TLIP) block on postoperative pain in patients with spinal surgery.
Plan blocks are used as a good and safe option for multimodal analgesia techniques in
postoperative pain control in spinal surgery.
The ESP block was first described in 2016 for the treatment of thoracic neuropathic pain.
In the following process; ESP block has been reported to provide effective postoperative
analgesia in thoracic and breast surgery, bariatric surgery and upper abdominal surgery.
Finally, ESP block has been reported to provide effective postoperative analgesia in
veretebra surgeries.
The mechanism of ESP analgesic action has been demonstrated in cadaver studies where injected
local anesthetics are caused by diffusion of the spinal nerves into the ventral and dorsal
ramycin by spreading in the cranial and caudal directions.
ESP block relieves incisional pain by creating an effective block in a wide area of the
posterior, lateral and anterior thoracic and lumbar walls.
In addition, ESP block prevents visceral autonomic pain and provides good postoperative
analgesia.
The thoracolumbar interfacial plan block (TLIP) is the other para-spinal plan block.
In this ultrasound guided block, local anesthetic targets the dorsal branches of the
thoracolumbar nerves by spreading between the facies of the multifidus and longissimus
muscles at the 3rd lumbar spine.
In this way, it has been reported to provide effective analgesia in spinal surgeries.
Routine ultrasonography guided ESP block or TLIP blog was planned randomly. Peroperative
analgesia plan will be applied to all patients in the same way. In this protocol intravenous
paracetamol was 1 g and tramadol was 1 mg / kg. Paracetamol and tramadol infusions are then
administered every eight hours.
Postoperative analgesia protocol: At the end of the operation, pain levels will be recorded
by the Numeric Rating Scale (NRS) system at 30 minutes, 1.6, 12, and 24 hours after the first
admission to the recovery room.
Tramadol PCA and paracetamol were administered to the patient every eight hours.
During the follow-up of the patient, it is planned to continue NRS follow-up. In this period,
intramuscular 75 mg diclofenac sodium will be administered if NRS is 4 or above.The amount of
analgesia consumption, recovery analgesia needs and times will be noted in detail.
When the patient is mobilized and discharged will be recorded.
The aim of this study was to compare the efficacy of erector spina plan(ESP) block and
thoraco lumbar interfacial(TLIP) block on postoperative pain in patients with spinal surgery.
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