Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Apr 25;18(1):318.
doi: 10.1186/s13018-023-03798-2.

The efficacy of thoracolumbar interfascial plane block for lumbar spinal surgeries: a systematic review and meta-analysis

Guanghua Long  1 , Chong Liu  1 , Tuo Liang  1 , Xinli Zhan  2
Affiliations
Meta-Analysis

The efficacy of thoracolumbar interfascial plane block for lumbar spinal surgeries: a systematic review and meta-analysis

Guanghua Long et al. J Orthop Surg Res. .

Abstract

Background: The intent of this meta-analysis was to examine the efficacy of thoracolumbar interfascial plane block (TLIP) for pain control after lumbar spinal surgery.

Methods: Randomized controlled trials (RCTs) published on PubMed, CENTRAL, Scopus, Embase, and Web of Science databases up to February 10, 2023, comparing TLIP with no or sham block or wound infiltration for lumbar spinal surgeries were included. Pain scores, total analgesic consumption, and postoperative nausea and vomiting (PONV) were analyzed.

Results: Seventeen RCTs were eligible. Comparing TLIP with no block or sham block, the meta-analysis showed a significant decrease of pain scores at rest and movement at 2 h, 8 h, 12 h, and 24 h. Pooled analysis of four studies showed a significant difference in pain scores at rest between TLIP and wound infiltration group at 8 h but not at 2 h, 12 h, and 24 h. Total analgesic consumption was significantly reduced with TLIP block as compared to no block/sham block and wound infiltration. TLIP block also significantly reduced PONV. GRADE assessment of the evidence was moderate.

Conclusion: Moderate quality evidence indicates that TLIP blocks are effective in pain control after lumbar spinal surgeries. TLIP reduces pain scores at rest and movement for up to 24 h, reduces total analgesic consumption, and the incidence of PONV. However, evidence of its efficacy as compared to wound infiltration of local anesthetics is scarce. Results should be interpreted with caution owing low to moderate quality of the primary studies and marked heterogeneity.

Keywords: Analgesia; Pain; Regional anesthesia; Spinal surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study flowchart
Fig. 2
Fig. 2
Meta-analysis of pain scores at rest between TLIP and no block/sham block
Fig. 3
Fig. 3
Meta-analysis of pain scores at rest between TLIP and wound infiltration
Fig. 4
Fig. 4
Meta-analysis of pain scores at movement between TLIP and no block/sham block
Fig. 5
Fig. 5
Meta-analysis of total analgesic consumption between TLIP and no block/sham block
Fig. 6
Fig. 6
Meta-analysis of total analgesic consumption between TLIP and wound infiltration
Fig. 7
Fig. 7
Meta-analysis of PONV between TLIP and no block/sham block
Fig. 8
Fig. 8
Risk of bias among studies
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Meng B, Bunch J, Burton D, Wang J. Lumbar interbody fusion: recent advances in surgical techniques and bone healing strategies. Eur Spine J. 2021;30:22–33. doi: 10.1007/S00586-020-06596-0. - DOI - PubMed
    1. Subramanian P, Ramasamy S, Ng KH, et al. Pain experience and satisfaction with postoperative pain control among surgical patients. Int J Nurs Pract. 2016;22:232–238. doi: 10.1111/IJN.12363. - DOI - PubMed
    1. Gazelka HM, Leal JC, Lapid MI, Rummans TA. Opioids in older adults: indications, prescribing, complications, and alternative therapies for primary care. Mayo Clin Proc. 2020;95:793–800. doi: 10.1016/J.MAYOCP.2020.02.002. - DOI - PubMed
    1. Samuel AM, Lovecchio FC, Premkumar A, et al. Use of higher-strength opioids has a dose-dependent association with reoperations after lumbar decompression and interbody fusion surgery. Spine (Phila Pa 1976) 2021;46:E203–E212. doi: 10.1097/BRS.0000000000003751. - DOI - PMC - PubMed
    1. Kowalski C, Ridenour R, McNutt S, et al. Risk factors for prolonged opioid use after spine surgery. Glob Spine J. 2021 doi: 10.1177/21925682211003854. - DOI - PMC - PubMed

LinkOut - more resources