Analgesic Efficacy of the Novel Intra- Semispinal Fascial Plane Block in Posterior Cervical Spine Surgery

Zagazig University52 enrolled

Overview

Posterior cervical spine surgery often requires a large posterior midline incision, resulting in poorly controlled postoperative pain, which arises from iatrogenic mechanical damage, intraoperative retraction, and resection to structures such as bone, ligaments, muscles, intervertebral discs, and zygapophysial joints.

Ultrasound-guided Inter-semispinal plane (ISP) block, was proposed as a novel technique for analgesia in posterior cervical spine surgeries. The ISP block involves an injection of local anesthetic into the fascial plane between the semispinalis cervicis and semispinal capitis muscles and results in blocking the dorsal rami of the cervical spinal nerves. ISP block can provide effective analgesia in posterior cervical spine surgery

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

DOUBLE

Enrollment

Conditions

Cervical Spine Surgery

Interventions

Inter-semispinal plane blockPROCEDURE

Ultrasound Inter-semispinal plane block in block group

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients' acceptance. * ASA I , II andIII . * Age between 18 years up to 70 years in both sexes. * Patients with a BMI (body mass index) ranging from 18.5 to 30 kg/m2. * Patients who scheduled for elective posterior cervical spine surgeries Exclusion Criteria: * Uncooperative patients * Coagulopathy. * Local tissue infection. * Allergy to local anesthesia.

Locations (2)

Faculty of Medicine, Zagazig University

Zagazig, Egypt

Faculty of medicine

Zagazig, Egypt

Outcomes

Primary Outcomes

Total morphine consumed for 24 hours postoperative will be calculated.

Calculation of total morphine that will be used postoperatively. Postoperative morphine will be considered if the postoperative VAS score \>3 or the patient requested additional analgesia. Rescue analgesia of intravenous morphine will be given

Time frame: Total morphine consumed up to 24 hours postoperative

Secondary Outcomes

Total fentanyl consumed intraoperative will be calculated

Total intraoperative fentanyl consumption including the induction doses (1mic/ kg) plus the additional doses of fentanyl (from 0.5 to 1 mic) that will be given if heart rate or blood pressure increases above 20%.

Time frame: total fentanyl dose that will be used for entire operative time.

postoperative pain will be assessed using the Numerical Pain Score (NRS) score

Numerical Pain Score (NRS) ranges from 0 to 10, where 0 is no pain, and 10 is the worst pain imaginable. Adequate pain control will be considered at Numerical Pain Score (NRS) \< 4.

Time frame: NRS will be recorded 24 hours postoperative.

Data from ClinicalTrials.gov

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