Analgesic Efficacy of Mid-Transverse Process to Pleura (MTP) Block and Intrathecal Morphine in Idiopathic Scoliosis Patients Undergoing Posterior Spinal Fusion

Tanta University

Status: Completed

Conditions: Idiopathic Scoliosis; Intrathecal Morphine; Mid-Transverse Process Block; Posterior Spinal Fusion

Treatments: Drug: Morphine; Device: Ultrasound-Guided Mid-Transverse Process to Pleura (MTP) Block

Study type: Interventional

Funder types: Other

Identifiers

NCT06331143

36264PR551/2/24

Details and patient eligibility

About

The aim of this study is to compare the analgesic efficacy of mid-transverse process to pleura (MTP) block and intrathecal morphine in idiopathic scoliosis patients undergoing posterior spinal fusion surgery.

Full description

The postoperative period for idiopathic scoliosis patients undergoing posterior spinal fusion (PSF) is fraught with challenges, including adequate postoperative pain control and prolonged hospitalization.

Intrathecal opioids have been used to manage postoperative pain in pediatric patients for a wide variety of surgeries , including adolescent and adult PSF. Multimodal analgesic (MMA) regimens using several drugs and techniques are considered to be necessary for postoperative pain relief.

The mid-transverse process to pleura (MTP) block was first described as a modified paravertebral block in 2017. The local anesthetics (LAs) are administered between the transverse process and the pleura. This results in a LA spread to the dorsal and ventral rami in the paravertebral space through the fenestrations in the superior costotransverse ligament at the level of injection, and frequently to adjacent levels.

Enrollment: 40 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥ 18 years.
• Both sexes.
• American Society of Anesthesiology (ASA) physical status I-II.
• Idiopathic scoliosis patients undergoing posterior spinal fusion surgery.

Exclusion criteria

• Patient with morbid obesity (body mass index >40 kg/m2).
• Patients with pre-existing infection at block site.
• Known allergy to study drugs.
• Coagulation disorder.
• History of psychiatric illness.
• Pre-existing neurological deficits.
• Presence of any pre-operative pain or history of chronic pain.
• History of regular analgesic.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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40 participants in 2 patient groups

Mid-Transverse Process block (MTP) group

Experimental group

Description:

Patients will receive mid-transverse process to pleura (MTP) block after induction of anesthesia.

Treatment:

Device: Ultrasound-Guided Mid-Transverse Process to Pleura (MTP) Block

Intrathecal morphine (IM) group

Experimental group

Description:

Patients will receive intrathecal morphine in a dose of 12 μg/kg (max 1000 μg) immediately after induction of anesthesia.

Treatment:

Drug: Morphine