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.

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.

[1] Gerbershagen H J,Aduckathil S,Van Wijck A J,et al. Pain intensity on the first day after surgery:A prospective cohort study comparing 179 surgical procedures[J]. Anesthesiology, 2013, 118(4): 934-944. 

[2] Ntalouka M P,Brotis A G,Bareka M V,et al. Multimodal analgesia in spine surgery:An umbrella review [J]. World Neurosurg, 2021, 149:129-139. 

[3] Hu Li, Xiao Wangbin, Yu Lina, etc. Clinical study of ultrasound-guided improved thoracolumbar fascial space plane block in posterior lumbar decompression and fusion surgery [J]. Chinese Journal of Experimental Surgery, 2020, 37 (7): 1342-1344.

[4] Zeng Jingfen, Shao Xiuxia, Wang Yan, et al. Comparison of ultrasound-guided modified thoracolumbar fascial plane block and incision infiltration in the treatment of postoperative pain in lumbar spine surgery [J]. Clinical and Educational Journal of General Medicine, 2022, 20 (08): 689-691+705+769. DOI: 10.13558/j.cnki. issn1672-3686.2002-008.006.

[5] Sun Gaoyue, Zhong Xiaoqian, Zhang Qianqian, et al. The effect of improved thoracolumbar fascial plane block on postoperative recovery quality in patients undergoing lumbar decompression and fusion surgery [J]. Tianjin Medical Journal, 2023,51 (03): 286-289.

[6] Peng Huili, Chen Zutao, Li Xingxiao, et al. Comparison of the application effects of ultrasound-guided modified thoracolumbar fascial space plane block and bilateral erector spinae muscle plane block in thoracolumbar spine fracture surgery [J]. Henan Medical Research, 2023,32 (21): 3981-3984

[7] Karim WA,Bathla S,Malik S,et al.Comparison of ultra-soundguided ilioinguinal iliohypogastric nerve block with wound infiltration during pediatric herniotomy surgeries [J].Anesth Essays Res, 2020, 14(2): 243-247.

[8] Forero M,Adhikary S D,Lopez H, et al.The erector spinae plane block: a new analgesic technique in thoracic neuropathic pain[J].Reg Anesth Pain Med,2016,41( 5) : 621 - 627.

[9] Zhou Dalei, Wang Qingbao, Mao Mushroom, et al. Effect of ultrasound-guided erector spinae plane block on the incidence of delirium after lumbar spine general anesthesia surgery[J]. Tissue Engineering and Reconstruction Surgery, 2021, 17(5): 430 - 432.

[10] MELVIN J P, SCHROT R J, CHU G M, et al. Low thoracic erector spinae plane block for perioperative analgesia in lumbosacral spine surgery: a case series[J]. Can J Anaesth, 2018, 65(9): 1057-1065.

[11] HAND W R, TAYLOR J M, HARVEY N R, et al.Thoracolumbar interfascial plane (TLIP) block: a pilot study in volunteers[J]. Can J Anaesth, 2015, 62(11): 1196-1200.

[12] Christopher S,Gopal TVS,Vardhan V.Thoracolumbar interfascial plane block,way forward for awake endoscopic laminectomies[J].Indian J Anaesth,2020,64(5):436-437.

[13] Ahiskalioglu A,Yayik A M,Celik E C,et al. Ultrasound guidedmodified Thoracolumbar Interfascial Plane block for low back painmanagement[J]. J Clin Anesth, 2019, 54: 138 - 139.

[14] Cheng Chuanxi, Wang Jishang, Zhou Mi. Effect of ultrasound-guided thoracolumbar fascia plane block on intravenous analgesia after single-segment lumbar spine fracture [J]. Journal of Clinical Anesthesiology, 2019, 35(9) :854 - 857.

[15] Wu J, Yang YB, Dong XY, et al. Progress of clinical application of ultrasound-guided erector spinae plane block [J]. Journal of Clinical Anesthesiology, 2019, 35( 6) : 604 - 607.