Regional Nerve Blocks to Improve Analgesia and Recovery in Older Adults Undergoing Spinal Fusion

Launched by UNIVERSITY OF IOWA · Jul 12, 2022

Keywords

ClinConnect Summary

This clinical trial is investigating a method called thoracolumbar interfascial plane (TLIP) blocks to help manage pain and improve recovery in older adults undergoing spinal fusion surgery. The TLIP block involves using anesthesia to numb the area around the spine, which has been shown in earlier studies to reduce post-surgery pain. This study is focused on understanding how easy it is to recruit participants, gather feedback, and identify any challenges in using this technique. The goal is to collect information that will help plan a larger study to see how effective TLIP blocks are at reducing pain, improving mobility, and decreasing the use of opioids and the risk of delirium in older adults.

To be eligible for this study, participants must be 65 years or older and scheduled for elective lumbar spinal fusion surgery involving three or fewer vertebrae. They should not have severe heart or lung problems, cognitive issues like dementia, or other significant health conditions that could complicate the procedure. If participants join the study, they can expect to receive the TLIP block before their surgery and will be asked to provide feedback about their experience. This trial is currently recruiting participants and aims to improve pain management approaches for older adults undergoing back surgery.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Are 65 or older
• • Indicated for lumbar spinal fusion of less than or equal to 3 levels
• • Undergoing elective surgery
• • no contraindications to local anesthetic or procedures
• • no severe cardiac or respiratory disease
• • no preexisting cognitive dysfunction/dementia
• Exclusion Criteria:
• • 64 years old and younger
• • emergency treatment
• • pathologic fractures
• • seeking revision surgery
• • major liver or kidney dysfunction
• • coexisting hematological disorder or irreversible abnormal coagulation
• • patients with previous diagnosis of dementia or SLUMS score \<20
• • patient unable to communicate/cooperate/language barrier
• • BMI\>40
• • allergy to study medications
• • opioid tolerant (oral opioid intake morphine equivalent =\< 60 mg/day)
• • other sources of chronic pain like fibromyalgia
• • patients with associated significant CNS or respiratory disease (home oxygen requirements)
• • incarcerated patients
• • psychiatric illnesses preoperative neurological deficits greater than one motor group, less than three out of five motor functions
• • pregnant or breast feeding