Ultrasound Guided Local Anesthetic Block: Thoracolumbar Interfascial Plane (TLIP)

Medical University of South Carolina (MUSC)

Status and phase: Completed; Phase 1

Conditions: Healthy

Treatments: Drug: Ropivicaine; Procedure: Thoracolumbar Interfascial Plane Block

Study type: Interventional

Funder types: Other

Identifiers

NCT02297191

Pro00033609 (Other Identifier)

TLIP Block

Details and patient eligibility

About

The purpose of the study is to determine the effectiveness of a new approach to numbing (anesthetizing) nerves in the back and to measure how far the area of anesthesia extends on the skin of the back.

Full description

This research aims to define a novel field-infiltration nerve block. We will use ultrasound guidance to inject local anesthesia into the potential space between the muscle bodies of the erector spinae. The medial branch of the dorsal ramus of each thoracolumbar nerve innervates the muscle and skin overlying the erector spinae muscle to the midline. By anesthetizing each nerve we believe minimally invasive (1-2 level) back surgery may be completed with less pain and preclude the side-effect laden opioid analgesics.

Enrollment: 10 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Healthy Adult

Exclusion criteria

• Pregnant women (a urine pregnancy test will be done on all females of childbearing age)
• Liver dysfunction
• Elderly
• Impaired cardiovascular function
• Individuals on amiodarone or history of back surgery
• History of medical allergy to local amide type local anesthetics
• Medical allergy to chlorhexidine
• History of paresthesias
• Inability to lay flat
• Home oxygen requirement
• History of seizures
• Only adults will be eligible.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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10 participants in 1 patient group

Thoracolumbar Interfascial Plane Block

Experimental group

Description:

All participants will have two injections at the same vertebral level on each side of the back. Each injection will consist of four 5cc incremental injections with aspiration prior to each 5cc of injectate of 0.5% Ropivicaine. . Each side of the back will be injected with 20cc of .05% Ropivicaine. Ultrasound will be used in real time to guide the needle, evaluate for "spread" of local anesthesia and to minimize the risk of Ropivicaine being injected intravascularly. a. Ultrasound images will be saved using the nomenclature TLIP Anat

Treatment:

Procedure: Thoracolumbar Interfascial Plane Block

Drug: Ropivicaine