50 Participants Needed

Thoracolumbar Block for Spinal Fusion Recovery

AR
CR
Overseen ByCatherine R Olinger, MD
Age: 65+
Sex: Any
Trial Phase: Phase < 1
Sponsor: University of Iowa
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 2 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new method for managing pain in older adults undergoing spinal fusion surgery. It employs a special anesthesia technique called a Thoracolumbar Interfascial Plane (TLIP) block, similar to a numbing shot given to the back during surgery, to determine its effectiveness in reducing pain and other postoperative issues. The study will also assess patient recruitment and trial completion, with the goal of planning a larger study in the future. Suitable candidates are those aged 65 or older, planning specific back surgery, without severe heart or lung problems, and without existing severe cognitive issues. As an Early Phase 1 trial, this research aims to understand how the TLIP block works in people, offering participants the opportunity to be among the first to benefit from this innovative pain management approach.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, if you are opioid tolerant (taking more than 60 mg of morphine equivalent per day), you may not be eligible to participate.

What prior data suggests that the TLIP block is safe for spinal fusion recovery?

Research has shown that TLIP blocks with bupivacaine can help manage pain after spinal surgery. In studies, patients who received TLIP blocks reported less pain and required fewer pain medications post-surgery. This suggests that the treatment is generally well-tolerated by those undergoing spinal surgery.

The TLIP block also aids in recovery. Patients often report better pain relief and higher satisfaction with their recovery process. Some studies indicate that patients experience fewer side effects compared to those who do not receive the block.

These findings suggest that TLIP blocks might be a safe option for managing pain in spinal fusion surgeries. However, as this trial is in an early stage, gathering more data to confirm these results remains important.12345

Why are researchers excited about this trial?

Researchers are excited about the Thoracolumbar Interfascial Plane (TLIP) Block of bupivacaine because it offers a new approach to enhancing recovery after spinal fusion surgery. Unlike typical treatments that rely solely on standard anesthesia, this technique involves administering a local anesthetic directly to the thoracolumbar area, potentially improving pain management and reducing the need for additional pain medications post-surgery. This targeted delivery method not only aims to provide more effective pain relief but also minimizes systemic side effects, which is a significant advantage over conventional anesthesia options.

What evidence suggests that the TLIP block is effective for spinal fusion recovery?

This trial will compare the effectiveness of thoracolumbar interfascial plane (TLIP) blocks with standard anesthesia in managing pain after spinal fusion surgery. Studies have shown that TLIP blocks effectively manage pain following spinal surgeries. Patients receiving TLIP blocks report less pain both at rest and during movement for up to 24 hours and often require fewer pain medications post-surgery. Research indicates that patients experience better recovery, with improved pain levels and overall quality of recovery. This suggests that TLIP blocks could be a promising option for managing pain after spinal fusion surgery.23678

Who Is on the Research Team?

CR

Catherine R Olinger, MD

Principal Investigator

Clinical Assistant Professor

Are You a Good Fit for This Trial?

This trial is for adults aged 65 or older who need lumbar spinal fusion surgery of up to three levels and have no severe heart, lung diseases, cognitive dysfunction, or allergies to local anesthetics. It's not for those with major liver/kidney issues, opioid tolerance, other chronic pain conditions, significant neurological deficits, psychiatric illnesses, under age 65, pregnant/breastfeeding women or those with a high BMI.

Inclusion Criteria

I am scheduled for a planned surgery.
I am recommended to have a spinal fusion surgery for up to 3 spine levels.
I do not have serious heart or lung conditions.
See 3 more

Exclusion Criteria

I take less than or equal to 60 mg/day of opioids.
I have a chronic pain condition like fibromyalgia.
I am 64 years old or younger.
See 13 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive standard of care anesthesia with or without TLIP Block of bupivacaine during spinal fusion surgery

1 day
1 visit (in-person)

Post-operative Monitoring

Participants are monitored for changes in pain, opioid use, and other health outcomes immediately after surgery and at various intervals up to 12 weeks post-operatively

12 weeks
Multiple visits (in-person and virtual) at 1 day, 2 days, 3 days, 2 weeks, 6 weeks, and 12 weeks post-operatively

Follow-up

Participants are monitored for safety and effectiveness after treatment, including 90-day readmission rates and disposition to skilled facilities

16 months

What Are the Treatments Tested in This Trial?

Interventions

  • Thoracolumbar Interfascial Plane (TLIP) Block of bupivacaine
Trial Overview The study tests the effectiveness of TLIP blocks using bupivacaine anesthesia in reducing post-operative pain and improving recovery in older adults after spinal fusion. It aims to assess feasibility for a larger trial by looking at recruitment rates and patient feedback on this pain management technique.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Standard of Care Anesthesia with Thoracolumbar Interfascial Plane (TLIP) Block of bupivacaineExperimental Treatment18 Interventions
Group II: Standard of Care Anesthesia without Thoracolumbar Interfascial Plane (TLIP) Block of bupivicaine.Active Control17 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Iowa

Lead Sponsor

Trials
486
Recruited
934,000+

Published Research Related to This Trial

The thoracolumbar interfascial plane (TLIP) block significantly reduces postoperative pain in patients undergoing lumbar spine surgery, as evidenced by lower visual analog scale (VAS) scores for pain at rest and during movement compared to those receiving patient-controlled analgesia (PCA) alone, based on a meta-analysis of 9 randomized controlled trials involving 618 patients.
Patients receiving the TLIP block also experienced lower PCA consumption and fewer nausea rates, indicating that this technique not only enhances pain management but also improves overall patient comfort after surgery.
Efficacy of Thoracolumbar Interfascial Plane Block for Postoperative Analgesia in Lumbar Spine Surgery: A Meta-analysis of Randomized Clinical Trials.Hu, Z., Han, J., Jiao, B., et al.[2021]
The thoracolumbar interfascial plane block (TLIPB) is a minimally invasive and relatively safe technique that can provide effective postoperative analgesia after thoracolumbar spine surgery.
This block may reduce the need for opioids and improve recovery, although further clinical studies are needed to fully understand its analgesic benefits in spinal surgeries.
Thoracolumbar Interfascial Plane Block for Spinal Cord Stimulator System Implantation: A Case Series.Hoydonckx, Y., Kumar, P., Chin, KJ., et al.[2021]
The thoracolumbar interfascial plane (TLIP) block significantly reduces opioid consumption in the first 24 hours after spine surgery, with a mean difference of -16.00 mg compared to non-block care, based on a systematic review of 9 randomized controlled trials involving 539 patients.
TLIP block not only decreases the need for rescue analgesia and reduces postoperative nausea and vomiting, but it also outperforms wound infiltration in lowering opioid use, making it a more effective analgesic option for patients undergoing spine surgery.
Thoracolumbar interfascial plane block for postoperative analgesia in spine surgery: A systematic review and meta-analysis.Ye, Y., Bi, Y., Ma, J., et al.[2021]

Citations

The efficacy of thoracolumbar interfascial plane block for ...TLIP blocks are effective in pain control after lumbar spinal surgeries. TLIP reduces pain scores at rest and movement for up to 24 h, reduces total analgesic ...
Thoracolumbar Interfascial Plane (TLIP) block verses other ...The results of our systematic review include moderate-quality evidence that show TLIP blocks provide effective pain control after spinal surgery.
Thoracolumbar Block for Spinal Fusion RecoveryPatients receiving the TLIP block reported better recovery outcomes, as indicated by significant improvements in pain scores and quality of recovery (QoR-40) ...
Thoracolumbar Interfascial Plane Block in Spinal SurgeryThe TLIP block reduces postoperative pain intensity, opioid consumption, side effects, and requests for rescue analgesia after spinal surgery more than the no- ...
Retracted: Exploring the ThoracolumbarOverall, the TLIP block shows promise as an effective and potentially safer alternative for post-spine surgery pain management, potentially ...
Exploring the Thoracolumbar Interfascial Plane (TLIP) Block ...Overall, the TLIP block significantly impacts patient outcomes by enhancing pain control, satisfaction, and recovery trajectories in the post- ...
Effect of ultrasound-guided thoracolumbar interfascial plane ...In this study, the TLIP block appeared to result in shortened postoperative feeding time, reduced intestinal mucosal damage, mitigated ...
Efficacy of Thoracolumbar Interfascial Plane Block for ...In this meta-analysis, we evaluated the analgesic efficacy of TLIP block following lumbar spine surgery. The primary outcomes were the difference in visual.
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