Regional Nerve Blocks to Improve Analgesia and Recovery in Older Adults Undergoing Spinal Fusion

The registry criteria, word for word

What the trial wants to find out

This initial study is a feasibility study for implementing thoracolumbar interfascial plane, or TLIP, blocks in older adults undergoing spinal fusion. TLIP blocks are done by using anesthesia. In this case, it will be done to either side of the back where surgery will be performed. This has been shown to decrease pain the patients have post-operatively in previous research. In this study, the investigators will examine recruitment rates, completion of assessments, dropout rate, gather patient feedback, and identify barriers to performing TLIP. Further, this feasibility study will provide data to determine adequate sample size and refine methods and outcomes for a future randomized clinical trial. The ultimate goal is to perform a large, appropriately powered randomized control trial to determine the effect of TLIP blocks on pain, physical function and disability, opioid consumption, and delirium in older adult undergoing spinal fusion.

The 2 groups in the trial

• Standard of Care Anesthesia without Thoracolumbar Interfascial Plane (TLIP) Block of bupivicaine.Existing treatment, for comparison

  Subjects will receive standard of care anesthesia without TLIP Block of bupivicaine.

  Treatment: Blood Test, 3D CAM Delirium Severity Scoring, Generalized Anxiety Disorder 7-item (GAD-7) scale, Numerical Rating Score (NRS), PROMIS-Pain Interference, Oswestry Disability Index (ODI), Saint Louis University Mental Status Examination (SLUMs), Delirium Rating Scale-Revised-98 (DRS), Telephone Interview for Cognitive Status - Modified (TICS-M), Opioid Equivalents measured by Morphine Milligram Equivalents (MME), Patient Health Questionnaire depression scale (PHQ-8), Pain Catastrophizing, Fear Avoidance Beliefs Questionnaire (FABQ), Opioid Side Effects and Likeability Questionnaire, Daily Pain Trajectory, Tampa Scale of Kinesiophobia, and Quality of Recovery 15

• Standard of Care Anesthesia with Thoracolumbar Interfascial Plane (TLIP) Block of bupivacaineTreatment being tested

  Patient receives standard of care anesthesia with TLIP Block of bupivacaine (local anesthetic) intraoperatively after anesthesia administration and before spinal fusion.

  Treatment: Thoracolumbar Interfascial Plane (TLIP) Block of bupivacaine, Blood Test, 3D CAM Delirium Severity Scoring, Generalized Anxiety Disorder 7-item (GAD-7) scale, Numerical Rating Score (NRS), PROMIS-Pain Interference, Oswestry Disability Index (ODI), Saint Louis University Mental Status Examination (SLUMs), Delirium Rating Scale-Revised-98 (DRS), Telephone Interview for Cognitive Status - Modified (TICS-M), Opioid Equivalents measured by Morphine Milligram Equivalents (MME), Patient Health Questionnaire depression scale (PHQ-8), Pain Catastrophizing, Fear Avoidance Beliefs Questionnaire (FABQ), Opioid Side Effects and Likeability Questionnaire, Daily Pain Trajectory, Tampa Scale of Kinesiophobia, and Quality of Recovery 15