Comparison of analgesic efficacy of ropivacaine versus ropivacaine plus dexmedetomidine in modified thoracolumbar interfascial plane block in patients undergoing lumbar disc surgeries: A randomised controlled trial.

Background and Aims: Inadequate pain control can cause a delay in recovery; hence, adequate analgesia is of much importance. The thoracolumbar interfascial plane (TLIP) block is a relatively newer block which has shown promising effects in pain control. In this study, we aim to determine the efficacy and safety of dexmedetomidine in enhancing the impact of local anaesthetic in TLIP block in patients undergoing lumbar surgeries. Methods: 60 patients aged 18-70 years were randomised to Group Plain [modified TLIP block with 20 mL of 0.25% ropivacaine bilaterally with general anaesthesia (GA)] and Group Dexmed (modified TLIP block with 0.25% ropivacaine along with 0.5 µg/kg dexmedetomidine bilaterally with GA). The primary outcome was to assess the total perioperative opioid consumption in the first 24 h. The secondary outcomes were to assess pain score upon arriving in the post-anaesthesia care unit, time to first analgesic need after surgery, postoperative opioid consumption in 24 h, and incidence of adverse events, including nausea and vomiting. Continuous variables were analysed using an independent Results: The total perioperative opioid consumption in Group Plain was 653.33 [standard deviation (SD): 250.4 µg] and that in Group Dexmed was 523.6 (SD: 258.6 µg), with a mean difference of 129.67 [95% confidence interval (CI): -1.89, 261.22] ( Conclusion: TLIP block with dexmedetomidine as an adjuvant did not decrease cumulative fentanyl consumption as compared to TLIP block with ropivacaine alone. But the time to first request of analgesia was increased in the Group Dexmed.