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Article Dans Une Revue Spine Journal Année : 2023

Transversus Abdominis Plane Block for Anterior Lumbar Interbody Fusion: a randomized controlled trial

Résumé

Background context - Anterior Lumbar Interbody Fusion (ALIF) is a lumbar arthrodesis technique via an anterior approach that is less invasive than the posterior approaches. However, it is associated with specific pain in the abdominal wall. Purpose - The objective of this study was to determine whether performing a bilateral ultrasound-guided Transversus Abdominis Plane (TAP) block allows a reduction in morphine consumption in the first 24 hours after surgery. Study design - This study is a prospective single-center, randomized, double-blind study. Patient sample - Patients undergoing ALIF surgery were included and randomized into two groups. Both groups received a TAP block performed at the end of surgery with either ropivacaine or placebo. Outcome measures - The primary outcome measure was morphine consumption in the first 24 hours. The main secondary outcomes were immediate postoperative pain and opioid-related side effects. Methods - Intra- and postoperative anesthesia and analgesia protocols where standardized. A bilateral ultrasound-guided TAP block was performed with 75 mg (in 15 mL) of ropivacaine per side or isotonic saline serum depending on their assignment group. Results - Forty-two patients were included in the study (21 per group). Morphine consumption at 24 hours (28 mg [18-35] in the ropivacaine group versus 25 mg [19-37] in the placebo group (p=.503)) were not significantly different between the two groups. Conclusion - TAP block with ropivacaine or placebo provided a similar postoperative analgesia when associated with a multimodal analgesia protocol for ALIF.
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Dates et versions

hal-04088362 , version 1 (16-05-2023)

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Paternité - Pas d'utilisation commerciale

Identifiants

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Alice Coquet, Audrey Sion, Antoine Bourgoin, Mickael Ropars, Hélène Beloeil. Transversus Abdominis Plane Block for Anterior Lumbar Interbody Fusion: a randomized controlled trial. Spine Journal, 2023, 23 (8), pp.1137-1143. ⟨10.1016/j.spinee.2023.03.013⟩. ⟨hal-04088362⟩
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