RecruitingACTRN12625001437459

The Effectiveness of Retrolaminar and Modified Thoracolumbar Interfascial Plane Blocks in the Management of Opioid-Free Anesthesia in Lumbar Discectomy

Comparison of the Effects of Retrolaminar and Modified Thoracolumbar Interfascial Plane Blocks on Postoperative Pain and Recovery Under Opioid-Free Anesthesia Management in Patients Undergoing Lumbar Discectomy: A Prospective, Double-Blind Study

Sponsor

Onur KUCUK (Dokuz Eylül University)

Enrollment

70 participants

Start Date

Nov 20, 2025

Study Type

Interventional

Conditions

intervertebral disc displacement Lumbar Discectomy

Summary

This randomized, controlled, prospective study aims to compare the effects of Retrolaminar Block and Modified Thoracolumbar Interfascial Plane (mTLIP) Block on postoperative recovery parameters in patients undergoing lumbar discectomy under opioid-free general anesthesia.All participants will receive standardized general anesthesia without intraoperative opioid use. Preoperative pain sensitivity will be assessed using the Pain Sensitivity Questionnaire (PSQ) and Visual Analog Scale (VAS). The study's primary outcomes include the time from sevoflurane discontinuation to the first response to verbal command and the time to discharge from the post-anesthesia care unit (PACU), defined as reaching an Aldrete score greater than or equal to 9. Secondary outcomes include tracheal extubation time, postoperative VAS scores at specified intervals (30 min, 2 h, 4 h, 8 h, 12 h, and 24 h), time to first rescue analgesic request, total 24-hour analgesic consumption, and the incidence of postoperative nausea and vomiting.

Eligibility

Sex: Both males and femalesMin Age: 18 YearssMax Age: 65 Yearss

Inclusion Criteria5

Adults aged 18–65 years
ASA (American Society of Anesthesiologists) physical status I–II
Scheduled for elective one- or two-level lumbar discectomy under general anesthesia
Able to understand and provide written informed consent
Able to complete preoperative pain sensitivity assessments (PSQ, VAS)

Exclusion Criteria8

Patients with contraindications to block application (local infection, coagulopathy, allergy, etc.)
Patients with previous lumbar spine surgery
Patients with a history of opioid addiction or chronic pain management
Patients who are pregnant or lactating
Patients who cannot understand scoring tests due to mental retardation or communication difficulties
Patients who underwent a different anesthesia strategy due to an unplanned complication during the case
Patients who experienced significant blood loss (>1000 mL) or required intensive care during surgery
Patients who cannot actively participate in the research process or who cannot be monitored regularly

Interested in this trial?

Get notified about updates and connect with the research team.

Interventions

Group Retrolaminar Block (RLB): Participants in this group will receive an ultrasound-guided bilateral Retrolaminar Block (RLB) prior to the induction of general anaesthesia. The procedure involves t

Group Retrolaminar Block (RLB): Participants in this group will receive an ultrasound-guided bilateral Retrolaminar Block (RLB) prior to the induction of general anaesthesia. The procedure involves the injection of 18 mL %0.25 bupivakain, 2 mL (8 mg) deksametazon on each side into the retrolaminar space at the L3 vertebral level using an in-plane technique. The injection is performed under sterile conditions using a linear ultrasound probe to visualize the lamina and ensure correct needle placement. - Drug: 18 mL %0.25 bupivakain, 2 mL (8 mg) deksametazon; 20 mL per side - Mode of administration: Single-shot injection, ultrasound-guided - Timing: Applied once after general anesthesia induction and intubation. - Monitoring adherence: Procedure details and drug dosage are recorded in patient medical records and anaesthesia charts.