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NCT Number: NCT06725680

Retrolaminar Block Versus Erector Spinae Plane Block as Opioid-Free Anesthesia for Enhanced Recovery After Posterior Lumbar Discectomy

The aim of this study is to compare retrolaminar block and erector spine plane block as opioid-free anesthesia for enhanced recovery after posterior lumbar discectomy.

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Key information

Conditions

Retrolaminar Block Enhanced Recovery Erector Spinae Plane Block Lumbar Discectomy Opioid-free Anesthesia

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Tanta University

Tanta, El-Gharbia, 31527, Egypt

About this study

Lumbar discectomy is a common procedure for patients who experience leg and back pain due to disc problems. Effective pain management is crucial for timely discharge and successful rehabilitation.

Opioid-free anesthesia is a technique that avoids the use of opioids during surgery. Enhanced recovery after surgery (ERAS) pathways are helpful strategies for incorporating opioid-free pain management techniques into clinical practice.

Erector spine plane block (ESPB) and retrolaminar block (RLB) are considered to be compartment blocks or interfacial plane blocks. In these approaches, local anesthetics are assumed to penetrate the superior costotransverse ligament and reach the paravertebral space, although the needle tip is not advanced into the paravertebral space.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age from 18 to 65 years.
  • Both sexes.
  • American Society of Anesthesiology (ASA) physical status I-II.
  • Undergoing elective posterior lumbar discectomy under general anesthesia.

Exclusion criteria

  • Body mass index (BMI) >35 kg/m2.
  • Patients with disturbed mental status.
  • Allergies to the drugs used in the study.
  • Local infection at the puncture site.
  • Cardiac insufficiency.
  • Renal insufficiency.
  • Coagulopathy.
  • Chronic opioid use.

Treatment and study plan

Retrolaminar block

Other

Patients will receive retrolaminar block after the induction of general anesthesia.

Erector spinae plane block

Other

Patients will receive erector spinae plane block after the induction of general anesthesia.

Primary outcomes

  1. Time to the 1st rescue analgesia

    Time frame: 24 hours postoperatively

    Time from end of surgery to first dose of morphine administrated.

Secondary outcomes

  1. Recovery time

    Time frame: Till first response to verbal command (Up to 1 hour)

    Time from isoflurane discontinuation to the first response to verbal command

  2. Time to discharge

    Time frame: Till the Aldrete score is ≥9 (Up to 3 hours)

    Time from admission to the post-anesthesia care unit (PACU) to discharge from the PACU when the Aldrete score is ≥9) will be recorded.

  3. Intraoperative fentanyl consumption

    Time frame: Intraoperatively

    Additional fentanyl bolus dosages of 1 µg/kg IV will be administered if heart rate or mean arterial blood pressure elevated more than 20% of the baseline (after exclusion of other causes than pain).

  4. Total morphine consumption

    Time frame: 24 hours postoperatively

    Rescue analgesia of morphine will be given as 3 mg bolus if the numeric rating scale (NRS) > 3 to be repeated after 30 min if pain persists until the NRS < 4. NRS will be assessed at 0, 4, 6, 8, 12, 18, and 24 h postoperatively.

  5. Degree of pain

    Time frame: 24 hours postoperatively

    Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable").

  6. Length of hospital stay

    Time frame: Till discharge from hospital (Up to 1 week)

    Length of hospital stay will be recorded from the admission till discharge from hospital.

  7. Incidence of adverse events

    Time frame: 24 hours postoperatively

    Incidence of adverse events such as bradycardia, hypotension, nausea, vomiting, respiratory depression, or any other complication related to the block such as pleural perforation, hematoma, and intraspinal diffusion will be recorded.

Sponsors and collaborators

Lead sponsor

Tanta University

Other

Registry information

Official study title

Retrolaminar Block Versus Erector Spinae Plane Block as Opioid-Free Anesthesia for Enhanced Recovery After Posterior Lumbar Discectomy: A Randomized Trial

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Dec 10, 2024
Registry last updated
Nov 19, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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