Background context: Anterior lumbar interbody fusion (ALIF) is a lumbar arthrodesis technique via an anterior approach that is less invasive than the posterior approaches. However, it is associated with specific pain in the abdominal wall.
Purpose: The objective of this study was to determine whether performing a bilateral ultrasound-guided Transversus abdominis plane (TAP) block allows a reduction in morphine consumption in the first 24 hours after surgery.
Study design: This study is a prospective single-center, randomized, double-blind study.
Patient sample: Patients undergoing ALIF surgery were included and randomized into two groups. Both groups received a TAP block performed at the end of surgery with either ropivacaine or placebo.
Outcome measures: The primary outcome measure was morphine consumption in the first 24 hours. The main secondary outcomes were immediate postoperative pain and opioid-related side effects.
Methods: Intra- and postoperative anesthesia and analgesia protocols where standardized. A bilateral ultrasound-guided TAP block was performed with 75 mg (in 15 mL) of ropivacaine per side or isotonic saline serum depending on their assignment group.
Results: Forty-two patients were included in the study (21 per group). Morphine consumption at 24 hours (28 mg [18-35] in the ropivacaine group versus 25 mg [19-37] in the placebo group [p=.503]) were not significantly different between the two groups.
Conclusion: TAP block with ropivacaine or placebo provided a similar postoperative analgesia when associated with a multimodal analgesia protocol for ALIF.
Keywords: Analgesia; Anterior lumbar interbody fusion; Multimodal; Postoperative pain; Regional analgesia; Transversus abdominis plane block.
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