Ultrasound-Guided Thoracolumbar Interfascial Plane Block with and Without Dexamethasone: A Comparative Study in Patients Undergoing Lumbar Spine Surgeries

Abstract

Background: Thoracolumbar interfascial plane (TLIP) block is a novel regional anesthetic technique that can provide effective postoperative analgesia in patients undergoing lumbar spine surgeries. This block targets the dorsal rami of thoracolumbar nerves as they pass through the paraspinal muscles. Multilevel spine surgeries are often prolonged, requiring extended duration of postoperative analgesia. Objective: To compare the duration and quality of postoperative analgesia of TLIP block when given with and without dexamethasone as an additive to bupivacaine. Methodology: This was a prospective, double-blinded randomized study done on 20 patients undergoing two- or three-level lumbar spine surgeries. Ten patients in group C received 20 ml of 0.25% bupivacaine alone, whereas 10 patients in Group D received 8 mg dexamethasone along with 20 ml of bupivacaine for TLIP block before skin incision. Time for first analgesic request and pain scores using Wong–Baker Faces Pain Rating Scale were measured postoperatively. Results: The mean duration of sensory block was longer in group D when compared to group C (502.00 ± 95.13 vs. 383.5 ± 54.53 min with a P value of 0.001). The amount of rescue analgesic requirement was also higher in group C compared to group D. Conclusion: Dexamethasone, as an additive to bupivacaine, prolongs the duration and improves the quality of TLIP block for lumbar spine surgeries.

Keywords

• dexamethasone
• lumbar spine surgery
• postoperative analgesia
• tlip block