Transversus Abdominis Plane Block as Part of a Multimodal Analgesic Regimen in Patients Undergoing Anterior Lumbar Interbody Fusion: A Retrospective Cohort Study.

Autor:	Colón LF; Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA luiscolon@erlanger.org., White CC; Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA., Miles DT; Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA., Wilson AW; Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA., Salazar O; Anesthesiology Consultants Exchange, Erlanger Hospital, Chattanooga, TN, USA., Patel P; Erlanger Neurosurgery and Spine, Erlanger Hospital, Chattanooga, TN, USA., Miller J; Erlanger Neurosurgery and Spine, Erlanger Hospital, Chattanooga, TN, USA.
Jazyk:	angličtina
Zdroj:	International journal of spine surgery [Int J Spine Surg] 2023 Jun; Vol. 17 (3), pp. 426-433. Date of Electronic Publication: 2023 Apr 06.
DOI:	10.14444/8442
Abstrakt:	Background: Opioids are a mainstay for pain control in patients undergoing lumbar spine surgery but are associated with a high risk of dependence and significant adverse effects. Efforts continue to be made to utilize non-narcotic agents such as regional nerve block for pain control as part of a multimodal analgesia regimen. Recently, transversus abdominis plane (TAP) blocks have proven beneficial for patients undergoing lumbar fusion procedures. The purpose of this study is to evaluate the efficacy of TAP blocks for postoperative pain control and the effect on opioid consumption and hospital length of stay (LOS) in patients undergoing anterior lumbar interbody fusion (ALIF). Methods: A retrospective review of patients undergoing elective ALIF included collection of data on demographics, LOS, pain scores using visual analog scale (VAS), opioid consumption using morphine milligram equivalents (MME) from postoperative day (POD) 0 to 5, and any complications. Patients who underwent primary ALIF or ALIF with concomitant posterolateral lumbar fusion were included. Results: A total of 99 patients met inclusion criteria; 47 had a preoperative TAP block and 52 did not. Demographic data and number of levels fused were equally distributed between the groups. The TAP group had significantly lower MME consumption postoperatively during POD 0 to 2 and 0 to 5. VAS pain scores were lower for TAP block patients on POD 3 and 4; otherwise, there was no significant difference. LOS and complication rates were not significantly different. A multiple regression analysis found male sex to be a predictor of increased postoperative MME, while age and TAP block were significant predictors of decreased MME. Conclusions: The use of TAP block for patients undergoing ALIF was associated with less cumulative MME consumption in the immediate postoperative period. TAP block may be an effective tool for reducing postoperative opioid consumption in patients undergoing ALIF. Clinical Relevance: The data in this study provide clinical relevance supporting the use of TAP blocks for patients undergoing ALIF procedures. Competing Interests: Declaration of Conflicting Interests : The authors report no conflicts of interest in this work. (This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2023 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.)
Databáze:	MEDLINE
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