Major spine surgery with multilevel instrumentation is followed by a large amount of opioid consumption, significant pain, and difficult mobilization Pain is one of the main factors limiting ambulation, increasing the risk of thromboembolism by immobility, and causing metabolic changes that affect other systems. Therefore, individualized pain management with the use of appropriate analgesic techniques is of paramount importance. Moreover, early intervention in rehabilitation aiming at a better postoperative recovery may reduce the length of hospital stay and return to daily activity. Effective pain management is one of the crucial components in enhanced recovery after surgery (ERAS).
Numerous regional anesthetic techniques have been used to provide analgesia following cervical spine surgery, including patient-controlled epidural analgesia, cervical paravertebral block, cervical plexus block, cervical erector spinae plane blocks, and local infiltration analgesia, however, each of these techniques has specific limitations that prevent them from being the analgesic technique of choice for such surgeries.
Up to the author's knowledge, there is no study done to compare multifidus cervicis plane block versus inter-semispinal plane block in a randomized controlled clinical trial as preemptive analgesia in patients undergoing cervical spine surgery.
Patient acceptance.
Age 21-60 years old.
BMI ≤ 30 kg/m2
ASA I - II.
History of allergy to the LA agents used in this study
Skin lesion at the needle insertion site,
Those with bleeding disorders, sepsis, liver disease, and psychiatric disorders
History of chronic pain and taking analgesics
Parallel
control group
Procedure/Surgerypatients will be operated under general anesthesia
MCP group
Procedure/Surgerypatients will receive ultrasound-guided MCP block with 15 ml of bupivacaine 0.25% on each side followed by general anesthesia.
ISP group
Procedure/Surgerypatients will receive ultrasound-guided ISP block with 15 ml of bupivacaine 0.25% on each side followed by general anesthesia.
changes in Visual analogue scale (VAS)score
On a scale of 0-10, the patient will learn to quantify postoperative pain where 0= No pain and 10= Maximum worst pain
Total dose of rescue analgesia
once the VAS score will be ≥ 3, rescue analgesia in the form of 0.1 mg/kg nalbuphine will be given and the total dose consumed will be recorded
the first time to rescue analgesia
the time from the end of operation to patient reporting VAS ≥ 3
Click on the lead sponsor to view all of their trials.
