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The effect of preemptive retrolaminar block on lumbar spinal decompression surgery

医学 麻醉 止痛药 围手术期 麻醉剂 外科 腰椎 减压 局部麻醉剂
作者
Kevser Peker,Gülçin AYDIN,İşın Gençay,Ayşe Gizem Saraçoğlu,Ahmet Tuğrul Şahin,Mustafa Öğden,Seydi Ali Peker
出处
期刊:European Spine Journal [Springer Nature]
标识
DOI:10.1007/s00586-024-08219-4
摘要

Abstract Purpose Spinal decompression surgery causes severe pain. Retrolaminar block (RLB) is block, which is done by infiltration of local anesthetic to block spinal nerves between the lamina and superior costotransversospinalis muscle. The primary aim of this study is to evaluate the effectiveness of RLB on postoperative analgesia in patients undergoing spinal surgery. Secondary aims are effects on additional anesthetic and analgesic consumption. Methods The sixty (60) patients who underwent lumbar spinal surgery between May 2020 and May 2021 under general anesthesia with or without applied preemptive RLB for postoperative analgesia were included in this prospective observational study. Group I received ultrasound-guided preemptive RLB. In Group II, no intervention was performed. Postoperative VAS scores were compared in groups as primary outcome, perioperative additional anesthetic and analgesic needs were compared as secondary outcome. Results There was a significant difference between the groups in favor of the RLB group in terms of postoperative VAS scores at rest [1.33 (0.33–3.509)] and movement [2.40 (1.20–4.00)] ( p < 0.001). Perioperative sevoflurane consumption was significantly low in block group ( p < 0.001). Postoperative tramadol consumption was lower in Group I compared with Group II [Group 1: 200 (100–300); Group 2: 37.5 (0–200); p < 0.001]. Conclusion Preemptive RLB may be used to reduce patients' pain in lumbar decompression surgery as well as to be part of a multimodal analgesia and anesthesia regimen to reduce anesthetic and analgesic drug consumption. Trial registration number ClinicalTrials.gov (No. NCT04209907).

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