Ueshima Hironobu, Ozawa Tomoyuki, Toyone Tomoaki, Otake Hiroshi
Department of Anesthesiology, Showa University Hospital, Tokyo, Japan.
Department of Orthopedics, Showa University Hospital, Tokyo, Japan.
Asian Spine J. 2017 Oct;11(5):722-725. doi: 10.4184/asj.2017.11.5.722. Epub 2017 Oct 11.
This paper was a single center-based retrospective study with prospective data collection.
Compared with other surgeries, limited options are available for perioperative pain management in spinal surgery. Therefore, we aimed to identify new pain management in this study.
The thoracolumbar interfascial plane (TLIP) block has been reported to provide effective regional analgesia in the lumbar region. This study investigated the efficacy of the TLIP block for pain management in lumbar laminoplasty.
We investigated patients who underwent lumbar laminoplasty for the treatment of lumbar spinal canal stenosis from April to October 2015. Patients with secondary surgery or surgery involving more than four intervertebral spaces were excluded. The primary outcome measure was the pain scale score within 48 hours after the surgery. The secondary outcomes were the number of additional analgesic drugs used and the number of patients complaining of complications, such as nausea and vomiting, within 24 hours after the surgery.
We retrospectively assessed the data of 44 patients who underwent lumbar laminoplasty. Of these, 25 patients received only general anesthesia (G group), whereas 19 patients received the TLIP block along with general anesthesia (T group). Compared with the G group, the T group reported lower pain scores for pain at 1, 2, 4, and 24 hours postoperatively. Moreover, the number of patients who received the additional analgesic pentazocine was lower in the T group than in the G group. The two groups showed no significant differences in the incidence of complications.
The TLIP block provides effective analgesia for 24 hours postoperatively in patients undergoing lumbar laminoplasty.
本文是一项基于单中心的回顾性研究，并进行前瞻性数据收集。
与其他手术相比，脊柱手术围手术期疼痛管理的选择有限。因此，我们旨在本研究中确定新的疼痛管理方法。
据报道，胸腰筋膜平面（TLIP）阻滞可在腰椎区域提供有效的区域镇痛。本研究调查了TLIP阻滞在腰椎椎板成形术中疼痛管理的疗效。
我们调查了2015年4月至10月接受腰椎椎板成形术治疗腰椎管狭窄症的患者。排除二次手术或涉及四个以上椎间隙的手术患者。主要结局指标是术后48小时内的疼痛量表评分。次要结局是术后24小时内使用的额外镇痛药数量以及抱怨恶心和呕吐等并发症的患者数量。
我们回顾性评估了44例接受腰椎椎板成形术患者的数据。其中，25例患者仅接受全身麻醉（G组），而19例患者在全身麻醉的同时接受了TLIP阻滞（T组）。与G组相比，T组术后1、2、4和24小时的疼痛评分较低。此外，T组接受额外镇痛药喷他佐辛的患者数量低于G组。两组并发症发生率无显著差异。
TLIP阻滞为接受腰椎椎板成形术的患者术后24小时提供有效的镇痛。
