• Bahadir Ciftci, Mürsel Ekinci, Erkan Cem Celik, Ahmet Murat Yayik, Muhammed Enes Aydin, and Ali Ahiskalioglu.
• Department of Anesthesiology and Reanimation, Medipol University School of Medicine, Istanbul, Turkey.
• World Neurosurg. 2020 Dec 1; 144: e849-e855.

ObjectiveThis study aimed to compare the ultrasound (US)-guided erector spinae plane block (ESPB) and modified-thoracolumbar interfascial plane (mTLIP) block for postoperative pain management in lumbar discectomy surgery patients.MethodsA total of 90 patients scheduled for lumbar discectomy were randomly assigned into 3 groups (n = 30 per group): an ESPB group, an mTLIP group, and a control group. In the ESPB and mTLIP groups, a single-shot US-guided block was administered with 20 mL of 0.25% bupivacaine bilaterally. All patients received intravenous patient-controlled postoperative analgesia with fentanyl, and 1 g intravenous paracetamol every 6 hours. Fentanyl consumption, Visual Analog Scale (VAS) pain scores, rescue analgesia, block procedure time, and side-effects were evaluated.ResultsPostoperative opioid consumption at all time intervals were significantly lower both in ESPB and mTLIP groups compared with the control group (P < 0.05). No significant difference was observed concerning intra- and postoperative opioid consumption between the ESPB and the mTLIP group (P < 0.001). Passive VAS score at the postanesthesia care unit, second, fourth, and eighth hours, and active VAS score at the postanesthesia care unit, second, fourth, eighth, and 16th hours were significantly lower in the ESPB and mTLIP groups compared with the control group (P < 0.05). The use of rescue analgesia was significantly lower in the ESPB and mTLIP groups than in the control group (9/30, 7/30, and 21/30, respectively, P < 0.001). The block procedure time was similar between groups (P = 0.198).ConclusionsUS-guided ESPB and mTLIP block may provide adequate pain control after discectomy surgery. However, there is a nonsuperiority between ESPB and the mTLIP groups.Copyright © 2020 Elsevier Inc. All rights reserved.

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