Effect of ultrasound-guided thoracolumbar interfascial plane block on postoperative recovery in patients undergoing posterior lumbar intervertebral fusion: a prospective observational study.

BACKGROUND

Posterior lumbar intervertebral fusion (PLIF) is a common surgical procedure, but postoperative gastrointestinal dysfunction remains a concern. This study evaluated the effect of ultrasound-guided thoracolumbar interfascial plane (TLIP) block on postoperative recovery in PLIF patients.

METHODS

This prospective observational study included patients undergoing PLIF at the First Affiliated Hospital of Bengbu Medical College between April 2023 and April 2024. The primary outcome was the plasma levels of intestinal-type fatty acid-binding protein (I-FABP).

RESULTS

The patients were grouped according to the intervention they received: TLIP block (TLIP group; n = 30) or isotonic saline (control group; n = 30). The mean age was 60.10 ± 9.67 years and 61.83 ± 9.52 years in the control and TLIP groups, respectively. The baseline characteristics were comparable between the two groups (all P > 0.05). Surgical duration and length of hospital stay did not significantly differ between groups (both P > 0.05). The time to initiate eating was longer in the control group compared with the TLIP group (8.85 ± 1.78 vs. 7.67 ± 1.55, P < 0.01). The I-FABP levels at T1-T4 in the control group were higher than in the TLIP group (all P < 0.001). The DAO levels at T1-T4 in the control group were higher than in the TLIP group (all P < 0.001). The MDA levels at T2-T4 in the control group were higher than in the TLIP group (all P < 0.001). The T-AOC levels at T1-T4 in the control group were lower than in the TLIP group (all P < 0.001). Postoperative constipation (20% vs. 10%, P < 0.01) and abdominal distension (10% vs. 7%, P < 0.01) were more common in the control group compared with the TLIP group.

CONCLUSIONS

TLIP block may improve postoperative recovery in patients undergoing PLIF, providing a novel approach to patient management. Larger-scale, multicenter studies with long-term follow-up are needed to validate the results.

CLINICAL TRIAL NUMBER: Not applicable.