RESUMO
BACKGROUND CONTEXT: Anterior lumbar interbody fusion (ALIF) is a lumbar arthrodesis technique via an anterior approach that is less invasive than the posterior approaches. However, it is associated with specific pain in the abdominal wall. PURPOSE: The objective of this study was to determine whether performing a bilateral ultrasound-guided Transversus abdominis plane (TAP) block allows a reduction in morphine consumption in the first 24 hours after surgery. STUDY DESIGN: This study is a prospective single-center, randomized, double-blind study. PATIENT SAMPLE: Patients undergoing ALIF surgery were included and randomized into two groups. Both groups received a TAP block performed at the end of surgery with either ropivacaine or placebo. OUTCOME MEASURES: The primary outcome measure was morphine consumption in the first 24 hours. The main secondary outcomes were immediate postoperative pain and opioid-related side effects. METHODS: Intra- and postoperative anesthesia and analgesia protocols where standardized. A bilateral ultrasound-guided TAP block was performed with 75 mg (in 15 mL) of ropivacaine per side or isotonic saline serum depending on their assignment group. RESULTS: Forty-two patients were included in the study (21 per group). Morphine consumption at 24 hours (28 mg [18-35] in the ropivacaine group versus 25 mg [19-37] in the placebo group [p=.503]) were not significantly different between the two groups. CONCLUSION: TAP block with ropivacaine or placebo provided a similar postoperative analgesia when associated with a multimodal analgesia protocol for ALIF.
