Research Evidence on Multifidus Plane Block
I cannot provide research articles specifically on multifidus plane block because none of the provided evidence discusses this technique. The evidence focuses on other regional anesthesia approaches for spine and thoracic surgery, but does not mention multifidus plane blocks.
What the Evidence Actually Covers
The provided literature discusses several alternative regional anesthesia techniques for spine surgery pain management, but multifidus plane block is notably absent:
Erector Spinae Plane Block (ESPB) for Lumbar Spine Surgery
ESPB is the most extensively studied fascial plane block for lumbar spine surgery and demonstrates superior analgesic efficacy 1, 2, 3, 4.
- Bilateral ultrasound-guided ESPB at T10-T12 level significantly reduces postoperative opioid consumption (31.9 mg vs 61.2 mg oral morphine equivalents at 24 hours) and pain scores compared to multimodal analgesia alone 2
- ESPB with 0.375% ropivacaine 40 mL provides superior analgesia compared to local wound infiltration (NRS 1.9 vs 5.9, P<0.001) after lumbar arthrodesis 3
- Single-shot ESPB at lumbar levels provides effective perioperative analgesia with minimal motor block and no interference with intraoperative neuromonitoring 1, 5
- Meta-analysis confirms ESPB significantly reduces postoperative opioid consumption and pain scores in lumbar spine surgery patients 4
Multimodal Analgesia Framework for Spine Surgery
NSAIDs and acetaminophen form the foundation of perioperative pain management and should be administered preemptively 6.
- Gabapentinoids (pregabalin/gabapentin) significantly reduce postoperative pain scores and opioid consumption when given preoperatively and continued postoperatively 7, 6
- Local anesthetic wound infiltration with bupivacaine provides immediate postoperative relief, with liposomal formulations extending duration up to 96 hours 6
- Opioids should be limited to 7 days maximum to avoid respiratory depression, tolerance, and addiction risk 8, 6
Other Regional Techniques Mentioned (Not Spine-Specific)
The evidence discusses paravertebral blocks, PECS blocks, serratus anterior plane blocks, and transversus abdominis plane (TAP) blocks for thoracic and abdominal surgery 8, but these are not relevant to lumbar spine surgery or multifidus plane blocks.
Clinical Bottom Line
If you are seeking evidence on fascial plane blocks for lumbar spine surgery, the erector spinae plane block has the strongest and most recent evidence base 2, 3, 4. The multifidus plane block may be a newer or less-studied technique that is not yet represented in major guidelines or high-quality systematic reviews. For current evidence-based practice in lumbar spine surgery analgesia, bilateral ESPB at T10-T12 combined with multimodal analgesia (NSAIDs, acetaminophen, gabapentinoids) represents the optimal approach 7, 6, 2, 3.