Academic Journal of Medicine & Health Sciences, 2024, 5(5); doi: 10.25236/AJMHS.2024.050504.
Bai Ronghua, Liang Yu, Gong Gu
Department of Anesthesiology, The General Hospital of Western Theater Command, Chengdu, Sichuan, 610083, China
The objective of this article was to analyze the analgesic effects and adverse reactions of ultrasound-guided modified thoracolumbar interfascial plane (mTLIP) block in patients undergoing lumbar surgery. We searched PubMe d, EMBASE, Springer, Cochrane Library, Chinese Biomedical Literature Database, CNKI, Wanfang Database and VIP database. Randomized controlled trial (RCT) to analyze the analgesic effect of mTLIP after lumbar surgery. Resting pain scores at 2h, 6h, 12h, 24h and 48h, respectively, the pain score of exercise state 24h after operation , the amount of sufentanil used after surgery, the number of PCIA press, the number of postoperative remedial analgesia, the incidence of adverse reactions such as nausea, vomiting and hypotension and the satisfaction rating were compared. A total of 4 RCTs meeting the criteria were obtained (n=286). Compared with the Control group, the experimental group showed a significant decrease at 2 hours post surgery (MD=-0.28, 95% CI -0.46~ -0.10, P=0.002), 12 hours post surgery (MD=-0.49, 95% CI -0.76~ -0.21, P=0.0006), 24 hours after surgery (MD=-0.54, 95% CI -0.76~ -0.31, P<0.00001) , 48 hours post surgery (MD=-0.46, 95% CI -0.66~ -0.26, P<0.00001) , the number of postoperative remedial analgesia (RR=0.35, 95% CI 0.18~ 0.67, P=0.002) , the incidence of nausea and vomiting (RR=0.35, 95% CI 0.17-0.72, P=0.004).There was no significant difference between the two groups at 6 hours post surgery, (MD=-0.21, 95% CI -0.41~ -0.00, P=0.05) ,24 hours after operation (MD=-0.21, 95% CI -0.46~ 0.04, P=0.10) ,the amount of sufentanil used after surgery (MD=-0.32, 95% CI -1.84~ 1.20, P=0.68),the number of PCIA press (MD=0.29, 95% CI -0.42~ 1.00, P=0.43) . the incidence of hypotension (RR=0.30, 95% CI 0.03~ 2.94, P=0.30). Compared with the Control group, the experimental group showed a significant increase at the satisfaction rating (MD=0.81, 95% CI 0.56~ 1.05, P< 0.00001). Ultrasound-guided mTLIP combined general anesthesia used in lumbar surgery can significantly reduce the postoperative resting state pain score, reduce the number of postoperative relief analgesia, reduce the incidence of postoperative nausea and vomiting, and higher postoperative satisfaction score.
Ultrasound; modified thoracolumbar interfascial plane; lumbar surgery; analgesia; Meta-analysis
Bai Ronghua, Liang Yu, Gong Gu. Meta-analysis of improved thoracolumbar interfascial plane block on postoperative analgesia and adverse reactions in patients undergoing lumbar surgery. Academic Journal of Medicine & Health Sciences (2024), Vol. 5, Issue 5: 21-28. https://doi.org/10.25236/AJMHS.2024.050504.
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