Retrolaminar Block for Post-Operative Analgesia in Patients Undergoing Lumbar Herniectomy Surgery

INTRODUCTION: Retrolaminar block (RLB) is a novel thoracic truncal block for analgesia for the thoracic and abdominal walls. However, the analgesic efficacy of RLB in patients undergoing selective lumbar herniectomy is not well known. The aim of this study is to determine the analgesic efficacy of RLB by measuring the pain intensity of patients with the Numeric Pain Rating Scale and evaluating the non-steroid anti-inflammatory drugs and opioid consumption after the surgery.
METHODS: Thirty patients with the American Society of Anesthesiologists physical status 1, 2, and 3 undergoing lumbar herniectomy of less than three levels between June 2019 and December 2019 were included in the study. The patients were evaluated in two groups: the RLB group (group R, n=15) and the intravenous (IV) analgesics group (group C, n=15). 10 mL 0.25% bupivacaine was applied bilaterally at the RLB. Tenoxicam, tramadol, and aldolan were administered as post-operative IV analgesic treatment. Numeric Rating Scale scores were evaluated at 2, 8, 12, 24, and 48 h after the surgery. Ketorolac and opioid consumption were evaluated at 24th and 48th h.
RESULTS: Compared with group C, group R exhibited lower pain scores at 2, 8, 12, and 24 h postoperatively (p<0.05 for each). Tenoxicam and tramadol doses at 24 and 48 h were lower in group R than the group C (p<0.05 for each).
DISCUSSION AND CONCLUSION: The retrolaminar block is an effective technique for post-operative analgesia in patients undergoing selective lumbar herniectomy within the first 24 h without significant complication.