Using Regional Nerve Blocks to Improve Pain Relief and Recovery in Adults 65 and Older Undergoing Lumbar Spinal Fusion Surgery

What this Trial Is About

Researchers are evaluating the use of thoracolumbar interfascial plane TLIP blocks in older adults undergoing spinal fusion surgery. This early phase study aims to test the feasibility of implementing TLIP blocks, which involve anesthesia applied to the back near the surgery site. The goal is to gather information on recruitment, assessment completion, dropout rates, patient feedback, and potential barriers to using TLIP blocks. This feasibility study will also help plan a larger randomized trial to assess the impact of TLIP blocks on pain, physical function, opioid use, and delirium in this population. Participants will be randomly assigned to one of two groups one receiving standard anesthesia care without TLIP blocks, and the other receiving standard anesthesia plus a TLIP block with bupivacaine during surgery. The TLIP block is given after anesthesia but before spinal fusion. The study includes various questionnaires and assessments related to pain, anxiety, depression, disability, delirium, and cognitive function. Blood tests will measure inflammation markers before and after surgery. During the study, participants will complete multiple assessments from before surgery up to 12 weeks post-operation, including pain scores, mental health evaluations, and delirium severity ratings. Researchers will monitor opioid use, side effects, hospital stay length, readmission rates, and disposition to care facilities over 16 months. The study will also collect patient-reported adverse events and use several detailed questionnaires to measure recovery and function after surgery.

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