A comparison of the effects of thoracolumbar interfascial plane (TLIP) block and erector spinae plane (ESP) block in postoperative acute pain in spinal surgery

Purpose: Spinal surgeries are a very painful procedure. New regional techniques for postoperative pain management are being considered. The present study aimed to evaluate the hypothesis that the ultrasound-guided erector spinae plane (ESP) block would lead to lower opioid consumption compared to the thoracolumbar interfascial plane (TLIP) block after lumbar disk surgery. The study's primary objective was to compare postoperative total opioid consumption, and the secondary objective was to assess postoperative pain scores. Methods: Sixty-eight patients who underwent elective lumbar disk surgery were randomly assigned to either the ESP block group or the TLIP block group. The current pain status of the patients in both the ESP and TLIP block groups was assessed using the Numerical Rating Scale (NRS) at specific time intervals (30 min, 1, 6, 12 and 24 h) during the postoperative period. The number of times patients administered a bolus dose of patient-controlled analgesia, (PCA) within the first 24 h was recorded. Results: In the ESP group, the total opioid consumption in terms of morphine equivalents was found to be significantly lower (ESP group: 7.7 ± 7.0; TLIP group: 13.0 ± 10.1; p < 0.05). The NRS scores were similar between the groups at 30 min, 1, 6, and 12 h, but at 24 h, they were significantly lower in the ESP group. Moreover, the groups had no significant difference regarding observed side effects. Conclusion: This study demonstrated the analgesic efficacy of both techniques, revealing that the ESP block provides more effective analgesia in patients undergoing lumbar disk surgery.