Regional analgesia techniques for lumbar spine surgery: a frequentist network meta-analysis

Author:

Hong Boohwi123ORCID,Baek Sujin12ORCID,Kang Hyemin12,Oh Chahyun12ORCID,Jo Yumin12ORCID,Lee Soomin12,Park Seyeon4

Affiliation:

1. Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital

2. Departments of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University

3. Biomedical Research Institute, Chungnam National University Hospital, Daejeon, Korea

4. Department of Nursing, College of Nursing, Chungnam National University

Abstract

Background: Various regional analgesia techniques are used to reduce postoperative pain in patients undergoing lumbar spine surgery. Traditionally, wound infiltration (WI) with local anesthetics has been widely used by surgeons. Recently, other regional analgesia techniques, such as the erector spinae plane block (ESPB) and thoracolumbar interfascial plane (TLIP) block, are being used for multimodal analgesia. The authors aimed to determine the relative efficacy of these using a network meta-analysis. Materials and methods: The authors searched PubMed, EMBASE, the Cochrane Controlled Library, and Google Scholar databases to identify all randomized controlled trials that compared the analgesic efficacy of the following interventions: ESPB, TLIP block, WI technique, and controls. The primary endpoint was postoperative opioid consumption during the first 24 hours after surgery, while the pain score, estimated postoperatively at three different time periods, was the secondary objective. Results: The authors included 34 randomized controlled trials with data from 2365 patients. TLIP showed the greatest reduction in opioid consumption compared to controls [mean difference (MD) =−15.0 mg; 95% CI: −18.8 to −11.2]. In pain scores, TLIP had the greatest effect during all time periods compared to controls (MD=−1.9 in early, −1.4 in middle, −0.9 in late). The injection level of ESPB was different in each study. When only surgical site injection of ESPB was included in the network meta-analysis, there was no difference compared with TLIP (MD=1.0 mg; 95% CI: −3.6 to 5.6). Conclusions: TLIP showed the greatest analgesic efficacy after lumbar spine surgery, in terms of postoperative opioid consumption and pain scores, while ESPB and WI are also alternative analgesic options for these surgeries. However, further studies are needed to determine the optimal method of providing regional analgesia after lumbar spine surgery.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

General Medicine,Surgery

Reference63 articles.

1. Development and validation of a clinical prediction score for poor postoperative pain control following elective spine surgery;Yang;J Neurosurg Spine,2021

2. Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway;Grotle;BMJ Open,2019

3. Mechanisms of postoperative pain;Kang;Anesth Pain Med,2016

4. Wound infiltration with local anesthetics for post-operative pain relief in lumbar spine surgery: a systematic review;Kjaergaard;Acta Anaesthesiol Scand,2012

5. Lumbar erector spinae plane block: successful control of acute pain after lumbar spine surgery – a clinical report;Brandao;Rev Esp Anestesiol Reanim,2019

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