A Comparative Study Between Ultrasound-Guided Erector Spinae Plane Block Versus Ultrasound-Guided Modified Thoracolumbar Interfascial Plane Block for Postoperative Analgesia in Lumbar Spinal Surgery

Background: Severe pain and suffering may result from postoperative pain following spinal surgery. When it comes to successful pain relief following spinal surgery, regional analgesia approaches might be the way to go. Two innovative interfascial plane blocks that can be used for postoperative analgesia after lumbar spinal surgery are the modified-Thoracolumbar Interfascial Plane (mTLIP) block and the Erector Spinae Plane Block (ESPB). Aim and objectives: To compare and contrast the mTLIP block with the ESP block in terms of analgesia, opioid intake, safety, and patient satisfaction after lumbar spinal surgery. Subjects and methods: Following formal clearance from the Institutional Review Board and Ethical Committee of Al-Azhar University Hospitals, this study was carried out on 120 patients from March 2023 to January 2025 and was randomized, prospective, comparative, and single blinded. Three equal groups were formed by random selection. Results: In patients who received both ESP and mTLIP, compared to those who received only general anesthesia, the ANOVA test showed that the time it took for the first analgesic request was statistically longer (P=0.531) and that the total amount of morphine consumed was statistically lower (P=0.861). In comparison to patients who underwent general anesthesia alone or who got mTLIP blocks, those who underwent ESP blocks reported significantly greater levels of patient satisfaction. Conclusion: The ESP block and mTLIP block provide superior, early postoperative analgesia and reduce stress response with less opioid consumption and side effects compared to the control group after lumbar spinal surgery. The ESP block is superior to the mTLIP block, safer, and easier to perform, with better patient satisfaction.