Background context:

ALIF (Anterior Lumbar Interbody Fusion) 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 TAP (Transversus Abdominis Plane) block allows a reduction in morphine consumption in the first 24 hours after surgery.

Study design:

This study is a prospective single-centre, 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 anaesthesia 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 vs 25 mg [19 – 37] in the placebo group (p=0.503)) were not significantly different between the 2 groups.

Conclusion:

TAP block with ropivacaine or placebo provided a similar postoperative analgesia when associated with a multimodal analgesia protocol for ALIF.