Modified Thoracolumbar Interfascial Plane Block On Postoperative Quality Of Recovery In Patients Undergoing Lumbar Decompression And Fusion

Objective Spine surgery involves the stripping of skin,muscle,fascia,and other tissues,and often causes severe pain after surgery.Recent years have witnessed a spurt of progress in ultrasound imaging technology,ultrasound-guided nerve block has become an important part of perioperative analgesia because of its simplicity and portability and high success rate.This paper focuses on the effect of dexmedetomidine compounded with ropivacaine for ultrasound-guided modified thoracolumbar interfascial plane block(m TLIP)on the quality of recovery in patients undergoing lumbar decompression and fusion.Methods Sixty patients undergoing lumbar decompression and fusion were divided into two groups(n=30)by a random number table method: modified thoracolumbar interfascial plane block group(group T)and control group(group C).The patients in group T was injected with 0.4% ropivacaine 20 m L+20 μg dexmedetomidine between the longissimus and iliocostalis muscles at the third lumbar spine vertebral level on each side under ultrasound guidance,while the patients in group C were not received nerve block.All patients received patient controlled intravenous analgesia(PCIA)after operation.When patients had a postoperative pain numerical rating scale(NRS)≥4,flurbiprofen ester 50 mg was given intravenously for remedial analgesia.The Qo R-15 scores of patients in both groups were recorded before and 24 hours after operative;The NRS for pain in both groups were recorded at 0.5,2,6,12,24 and 48 hours postoperatively;the area under curve(AUC)of NRS scores at rest and movement at 24 hours after surgery;the patient satisfaction scores,the number of PCIA presses and the use of remedial analgesia at 24 h after operation,postoperative nausea and vomiting.Results Compared with group C,patients in group T had higher Qo R-15 scores at 24 hours postoperatively,higher patient satisfaction scores,lower NRS scores at rest and movement at 0.5 h,2 h,12 h,24 h and 48 h postoperatively,lower AUC,fewer PCIA presses and lower rate of remedial analgesia at rest and movement(P<0.05).Conclusion Ultrasound-guided dexmedetomidine compounded with ropivacaine for modified thoracolumbar fascial plane nerve block can improve the quality of postoperative recovery in patients undergoing lumbar decompression and fusion,relieve postoperative pain,improve patient satisfaction and help promote early postoperative recovery.