The use of bilateral inter-semispinal plane block to effectively enhance the recovery pathway for posterior cervical surgery—A prospective randomized controlled study

Background: Bilateral inter-semispinal plane (ISP) block can be used to alleviate postoperative pain in patients underwent posterior cervical surgery, this study aimed to determine if bilateral ISP block can promote recovery after surgery for patients undergoing posterior cervical surgery. Methods: 100 patients were assigned randomly to either the control or ISP block group. The main outcome was the length of stay (LOS). The secondary outcomes include the Numerical Rating Scale(NRS) scores, times of PCIA press, and total consumption of rescue analgesic drugs. The patient’s postoperative life quality was evaluated using a 40-item quality of recovery score (QoR-40), time to first walk independently and oral intake. We also recorded postoperative negative outcomes. Result: The mean LOS in the ISP group was significantly shorter than that in the control group (7.52 ±1.34 vs. 8.98 ±1.32 days, P = 0.014). Within 24 h postoperatively, pain scores in the ISP block group were lower than in the control group ( P ＜ 0.001), however, the NRS scores at 48 h were not significantly different ( P = 0.631). The PCIA press times and pentazocine consumption in the ISP group were significantly reduced compared with those in the control group ( P ＜ 0.001). Postoperative total QoR-40 scores and its 4 dimensions were higher in the ISP group than in the control group ( P < 0.001), except the independence. Oral intake and unassisted walking in the ISP group were shorter than those in the control group ( P ＜ 0.001). Adverse effects were not different in neither group ( P > 0.05). Conclusion: Bilateral ISP block could significantly and safely promote recovery for patients undergoing posterior cervical surgery. Trial registration: The trial was registered at the Chinese Clinical Trial Registry (www.chictr.org.cn) (No: ChiCTR2300069813); 27/03/2023