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Research ArticleOriginal Article
Open Access

Investigation of the analgesic efficacy of ultrasound-guided thoracolumbar interfacial plane block in vertebral surgery

A prospective randomized clinical study

Hakan Tapar, Özgür Demir, Ali Genç, Mehtap G. Balta, Vildan Kölükçü, Tugba Karaman, Serkan Dogru, Serkan Karaman and Mustafa Suren
Saudi Medical Journal October 2022, 43 (10) 1136-1141; DOI: https://doi.org/10.15537/smj.2022.43.10.20220467
Hakan Tapar
From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
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  • For correspondence: [email protected]
Özgür Demir
From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
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Ali Genç
From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
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Mehtap G. Balta
From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
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Vildan Kölükçü
From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
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Tugba Karaman
From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
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Serkan Dogru
From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
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Serkan Karaman
From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
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Mustafa Suren
From the Department of Anesthesiology and Reanimation (Tapar, Balta, Kölükçü, T. Karaman, S. Karaman,); from the Department of Neurosurgery (Demir), Medical Faculty, Tokat Gaziosmanpasa University, from the Department of Anesthesiology and Reanimation (Genç), Turhal State Hospital, from the Department of Anesthesiology and Reanimation (Suren), Medical Faculty, Samsun University, Tokat, and from the Department of Anesthesiology and Reanimation (Dogru), Mersin City Hospital, Mersin, Turkey.
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    Figure 1

    - Consolidated Standards of Reporting Trials flow diagram.

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    Figure 2

    - Magnetic resonance anatomy for Thoracolumbar interfascial plane block. 1) Multifudus muscles; 2) longisumus muscles; 3) iliocastalis muscles; 4) transverse process; 5) spinous process

Tables

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    Table 1

    - Patients’ demographics and surgical data.

    VariablesGroup TGroup CP-values
    Gender
    Female17 (53.1)13 (40.6)0.316
    Male15 (46.9)19 (59.4)
    Age (year), mean±SD50.03±12.28651.13±11.2900.712
    BMI (kg/m2), mean±SD27.641±5.28428.526±4.3830.468
    ASA score
    I3 (9.4)7 (21.9) 
    II25 (78.1)19 (59.4)0.244
    III4 (12.5)6 (18.8) 
    Surgery type
    Spinal instrumentation16 (50.0)13 (40.6)0.451
    Lumbar discectomy16 (50.0)19 (59.4)
    Surgical duration (minute), median (min-max)193 (120-360)180 (90-420)0.709

    Values are presented as a number and precentage (%). SD: standard deviation, BMI: body mass index, ASA: American society of anesthesiologist, min: minimum, max: maximum

      • View popup
      Table 2

      - The postoperative visual analogue scale and Quality of Recovery-40 scores of the patients.

      VariablesGroup TGroup CP-values
      Postoperative VAS
      One hour2 (0-4)4 (1-8) 
      2 hours2 (0-4)4 (2-7) 
      6 hours1 (0-4)3 (1-7)0.000*
      12 hours1 (0-3)2 (0-5) 
      24 hours0 (0-2)2 (0-5) 
      QoR-40 total score181(135-197)186 (135-197)0.532
      PC53 (41-60)53 (35-60)0.946
      ES41.5 (30-45)44 (28-47)0.116
      PI23.5 (9-25)24 (5-25)0.927
      PS34 (24-35)34.5 (28-35)0.045
      P32 (23-34)31.5 (21-35)0.962

      Values are presented as a median (minimum-maximum). The Mann-Whitney-U test was used for statistical analyze. *statistically significant, VAS: visual analogue scale, QoR-40: quality of recovery-40, PC: physical comfort, ES: emotional state, PI: physical independence, PS: patient support, P: pain

        • View popup
        Table 3

        - The postoperative analgesic requirements of the patients.

        RequirementsGroup TGroup CP-values
        Postoperative tramadol consumption (mg), median (minimum-maximum)180 (100-260)210 (100-300)0.001*
        Additional analgesic requirement (mg), mean±SD0.375±1.0083.975±2.8950.000*
        Additional analgesic requirement, n (%)
        No28 (87.5)8 (25.0)0.000*
        Yes4 (12.5)24 (75.0)

        The Mann-Whitney-U test and Pearson Chi-square test were used for statistical analyze. *statistically significant, SD: standard deviation

          • View popup
          Table 4

          - The postoperative nausea and vomiting scores of the patients.

          VariablesGroup TGroup CP-values
          Nausea
          No22 (68.8)19 (59.4)0.434
          Yes10 (31.2)13(40.6)
          Vomiting
          No26 (81.3)24 (75.0)0.545
          Yes6 (18.9)8 (25.0)

          Variables are presented as a number and precentage (%). The Pearson Chi-square test was used for statistical analyze.

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          Investigation of the analgesic efficacy of ultrasound-guided thoracolumbar interfacial plane block in vertebral surgery
          Hakan Tapar, Özgür Demir, Ali Genç, Mehtap G. Balta, Vildan Kölükçü, Tugba Karaman, Serkan Dogru, Serkan Karaman, Mustafa Suren
          Saudi Medical Journal Oct 2022, 43 (10) 1136-1141; DOI: 10.15537/smj.2022.43.10.20220467

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          Investigation of the analgesic efficacy of ultrasound-guided thoracolumbar interfacial plane block in vertebral surgery
          Hakan Tapar, Özgür Demir, Ali Genç, Mehtap G. Balta, Vildan Kölükçü, Tugba Karaman, Serkan Dogru, Serkan Karaman, Mustafa Suren
          Saudi Medical Journal Oct 2022, 43 (10) 1136-1141; DOI: 10.15537/smj.2022.43.10.20220467
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          Keywords

          • nerve block
          • spine
          • postoperative period
          • pain
          • tramadol
          • morphine
          • analgesia
          • visual analog scale

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