Retrolaminar block for opioid-free anaesthesia and enhanced recovery after posterior lumbar discectomy: A randomised controlled study.

Autor: Kamel AAF; Department of Anaesthesia, Intensive Care and Pain Management, Faculty of Human Medicine, Zagazig University, Alsharkia, Egypt., Fahmy AM; Department of Anaesthesia, Intensive Care and Pain Management, Faculty of Human Medicine, Zagazig University, Alsharkia, Egypt., Medhat MM; Department of Anaesthesia, Intensive Care and Pain Management, Faculty of Human Medicine, Zagazig University, Alsharkia, Egypt., Ali Elmesallamy WAE; Department of Anaesthesia, Intensive Care and Pain Management, Faculty of Human Medicine, Zagazig University, Alsharkia, Egypt., Salem DAE; Department of Anaesthesia, Intensive Care and Pain Management, Faculty of Human Medicine, Zagazig University, Alsharkia, Egypt.
Jazyk: angličtina
Zdroj: Indian journal of anaesthesia [Indian J Anaesth] 2024 Mar; Vol. 68 (3), pp. 261-266. Date of Electronic Publication: 2024 Feb 22.
DOI: 10.4103/ija.ija_773_23
Abstrakt: Background and Aims: Intraoperative regional analgesia and enhanced recovery are standard care models aimed at reducing perioperative opioid use following spine surgeries. This study aimed to examine the analgesic effect of retrolaminar block in promoting recovery and pain relief after posterior lumbar discectomy.
Methods: The patients undergoing elective posterior lumbar discectomy were randomised into the retrolaminar group (n = 36) (received an intra-operative bilateral retrolaminar block with 15 mL of bupivacaine 0.25%, 2 mL (8 mg) of dexamethasone, and 2 mL of magnesium sulphate 10% (200 mg) on each side) and control group (n = 36) (received standard general anaesthesia). Primary outcomes were recovery time (time from isoflurane discontinuation to the first response to verbal command) and time to discharge (time from admission to the post-anaesthesia care unit (PACU) to discharge from the PACU, when Aldrete score was ≥9). P values < 0.05 were considered statistically significant.
Results: The extubation, recovery, and discharge times were significantly shorter in the retrolaminar group compared to the control group ( P < 0.001). Postoperative pain scores were significantly lower in the retrolaminar group for up to 8 h compared to only 2 h in the control group ( P < 0.001). The time to first administration of ketorolac post-operatively was significantly longer in the retrolaminar group compared to the control group ( P < 0.001). The total consumption of ketorolac post-operatively was significantly reduced in the retrolaminar group compared to the control group ( P < 0.001).
Conclusion: Intra-operative retrolaminar block is an easy and effective opioid-free regional anaesthesia technique that improves recovery after posterior lumbar discectomy.
Competing Interests: There are no conflicts of interest.
(Copyright: © 2024 Indian Journal of Anaesthesia.)
Databáze: MEDLINE
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