Korean J Anesthesiol.  2019 Aug;72(4):336-343. 10.4097/kja.d.18.00352.

The analgesic efficacy of the transversalis fascia plane block in iliac crest bone graft harvesting: a randomized controlled trial

Affiliations
  • 1Department of Anesthesia, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada. gasgenie@gmail.com
  • 2Department of Anesthesia, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.

Abstract

BACKGROUND
Iliac crest bone graft (ICBG) harvesting is associated with significant perioperative pain and opioid consumption. This randomized controlled trial sought to determine if the transversalis fascia plane (TFP) block provides effective analgesia for anterior ICBG harvesting.
METHODS
Fifty patients undergoing wrist fusion surgery with anterior ICBG harvesting were randomized to receive a TFP block with either 20 ml of 0.5% ropivacaine or 5% dextrose. Patients additionally received a brachial plexus block for primary surgical-site anesthesia and either a general or spinal anesthetic depending on patient preference. Primary outcomes of interest were perioperative opioid consumption (measured as intravenous morphine equivalents [IME]), pain intensity at the ICBG harvest site for up to 48 h postoperatively, and the incidence of persistent postoperative pain at 6 and 12 months after surgery.
RESULTS
The TFP group used less opioid in the post-anesthetic care unit (PACU) (median 0 vs. 2.5 mg IME, P = 0.01) and in the first 8 h following PACU discharge (median 2.5 vs. 13.0 mg IME, P = 0.02). The patients who received a TFP block also had lower pain scores in PACU (median 0 vs. 4.0 out of 10, P < 0.001). Although opioid consumption and pain scores were lower in the TFP group at later timepoints, this difference was not statistically significant. Persistent pain at the ICBG site was reported in only 4.3% and 6.5% of all patients at 6 and 12 months, respectively.
CONCLUSIONS
The TFP block provides effective early analgesia for anterior ICBG harvesting. The incidence of persistent postoperative pain was low.

Keyword

Anesthesia; Conduction; Fascia; Local anesthesia; Nerve block

MeSH Terms

Analgesia
Anesthesia
Anesthesia, Local
Brachial Plexus Block
Fascia*
Glucose
Humans
Incidence
Morphine
Nerve Block
Pain, Postoperative
Patient Preference
Transplants*
Wrist
Glucose
Morphine

Cited by  1 articles

Preemptive analgesic efficacy of ultrasound-guided transversalis fascia plane block in children undergoing inguinal herniorrhaphy: a randomized, double-blind, controlled study
Ibrahim Abdelbaser, Nabil A. Mageed, El-Sayed M. El-Emam, Mahmoud M. ALseoudy, Mohamed M. Elmorsy
Korean J Anesthesiol. 2021;74(4):325-332.    doi: 10.4097/kja.20601.

Full Text Links
  • KJAE
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr