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TLIP Block Versus Retrolaminar Block on Quality of Recovery After Posterior Lumbar Spine Fusion Surgery

ConditionsPostoperative PainSpinal Fusion SurgeryDegenerative Lumbar Spine Diseases
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-65
SponsorAssiut University

About this trial

This prospective randomized controlled study aims to compare the effects of ultrasound-guided thoracolumbar interfascial plane (TLIP) block versus retrolaminar block on postoperative quality of recovery in patients undergoing posterior lumbar spine fusion surgery. Despite advances in surgical techniques, lumbar spine fusion is associated with significant postoperative pain, which may delay recovery and increase opioid consumption.

Recent approaches emphasize multimodal analgesia and opioid-sparing strategies, including regional anesthesia techniques. Interfascial plane blocks, such as TLIP and retrolaminar block, have gained attention due to their safety and effectiveness in targeting the dorsal rami of spinal nerves supplying the posterior spinal structures.

The primary outcome of this study is postoperative quality of recovery assessed using the Quality of Recovery-15 (QoR-15) questionnaire at 24 hours. Secondary outcomes include pain scores, opioid consumption, time to ambulation, time to oral intake, and postoperative complications.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Adult patients aged 18-65 years

Male and female patients

Scheduled for elective one- or two-level posterior lumbar instrumented fusion surgery under general anesthesia

ASA physical status I-III

Disqualifiers

Patient refusal to participate

Coagulopathy or anticoagulant therapy

Infection at the site of block injection

Known allergy to local anesthetics

Trial design

Design model

Parallel

Treatments tested in this trial

  • Thoracolumbar interfascial plane block

    Procedure/Surgery

    Ultrasound-guided injection of local anesthetic into the fascial plane between the multifidus and longissimus muscles at the L3 level

  • Retrolaminar block

    Procedure/Surgery

    Ultrasound-guided injection of local anesthetic posterior to the vertebral lamina at the L3 level.

Treatment groups

70 Participants
are divided into 2 treatment groups
Group A: Thoracolumbar interfascial plane Block GroupExperimental treatment 1 intervention
Group B: Retrolaminar Block GroupExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Quality of Recovery-15 (QoR-15) score at 24 hours postoperatively

Quality of recovery will be assessed using the Quality of Recovery-15 (QoR-15) questionnaire, a validated 15-item patient-reported outcome measure. Scores range from 0 to 150, with higher scores indicating better postoperative recovery. The primary endpoint is the QoR-15 score at 24 hours after surgery.

Time frame
24 hours postoperatively

Secondary outcomes

1

Pain intensity using Visual Analog Scale (VAS)

Pain will be assessed using a 0-10 Visual Analog Scale, where 0 indicates no pain and 10 indicates worst imaginable pain.

Time frame
30 minutes, 2, 6, 12, and 24 hours postoperatively
2

Time to first rescue analgesia

Time from the end of surgery to the first request for rescue analgesia (VAS ≥ 4).

Time frame
Within 24 hours postoperatively
3

Total nalbuphine consumption

Total amount of nalbuphine administered within the first 24 hours after surgery (mg).

Time frame
24 hours postoperatively
4

Time to first ambulation

Time frame
From end of surgery to first ambulation, assessed up to 48 hours postoperatively

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Assiut University

Lead sponsor

Source ClinicalTrials.gov

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