the purpose of this study is to compare of better postoperative analgesia following lumber spine discectomy
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
144
The probe will be placed in the parasagittal plane at the level of the L3 vertebrae. The spinous process will be visualized, and the probe was moved 3 cm laterally from the midline. The erector spinae musclewill be visualized above the transverse process. The needle will be punctured in the craniocaudal direction using the in-plane technique. The needle will be directed superior to the transverse process . Then, 2 mL normal saline solution will be injected into the deep fascia of the erector spinae muscle to confirm the proper injection site. After ensuring the location of the needle, 20 mL of 0.25% bupivacaine will be administered. The same ESPB procedure will be performed on the other side. In total, 40 mL of 0.25% bupivacaine was administered
The probe will be placed vertically at the L3 vertebrae level. The spinous process and the interspinous muscles (i.e., multifidus, longissimus, and iliocostalis) will be visualized as the anatomic guide points. The probewill be moved laterally to identify the longissimus and iliocostalis muscles . The needlewill be inserted between the longissimus and iliocostalis in the medial-to-lateral direction using the in-plane technique. After confirming the location of the needle, 20 mL of 0.25% bupivacaine will be administered. The same mTLIP procedure will be performed on the opposite side. In total, 40 mL of 0.25% bupivacaine will be administered
faculty of medicine,zagazig university Egypt Ext. 002 K.Howida@yahoo.com
Zagazig, Egypt
Length of hospital stay
from the day of admission till discharge from hospital
Time frame: up to 1 weak postoperative.
The recovery time
time from discontinuation of isoflurane to first response to verbal command
Time frame: up to 30 minutes postoperative.
The time of discharge
The time from arrival to the PACU to discharge to the ward
Time frame: up to 2 hours postoperative.
6 minutes walk test
involves walking for 6 min on a 30 m walking path and measuring the distance
Time frame: 24 hours postoperative
Functional reach test
quantifies participants' dynamic in-place standing balance control to reach distance. The distance between the starting and maximal forward reach distance beyond the participant's arm length represents the reach distance and is recorded in centimeters
Time frame: 24 hours postoperative
Time up and go test
objective measure of functional disability that can be used to evaluate various activities such as standing, accelerating, walking, decelerating, and turning, which are often limited in patients with lumbar degenerative diseases
Time frame: 24 hours postoperative
Pain intensity
10-point NRS \[(0 = no pain, 10 = worst imaginable pain), 1 - 3: Mild pain (nagging, annoying, slightly interfering with activities of daily living (ADLs), 4 - 6: Moderate pain (significantly interfering with ADLs, 7 - 10: Severe pain (disabling, unable to perform ADLs)\]
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Time frame: 30 minutes after the end of the surgery, as well as 3, 6, 12, and 24 hours postoperatively
Time to first call analgesia
Time frame: 24 hours postoperative
Total naluphine consumption
Time frame: 24 hours post-operative