Analgesic Efficacy of Mid-Transverse Process to Pleura (MTP) Block and Intrathecal Morphine in Idiopathic Scoliosis Patients Undergoing Posterior Spinal Fusion

NCT ID: NCT06331143

Last Updated: 2026-01-29

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-03-28
• Study Completion Date: 2026-01-04

Brief Summary

The aim of this study is to compare the analgesic efficacy of mid-transverse process to pleura (MTP) block and intrathecal morphine in idiopathic scoliosis patients undergoing posterior spinal fusion surgery.

Detailed Description

The postoperative period for idiopathic scoliosis patients undergoing posterior spinal fusion (PSF) is fraught with challenges, including adequate postoperative pain control and prolonged hospitalization.

Intrathecal opioids have been used to manage postoperative pain in pediatric patients for a wide variety of surgeries , including adolescent and adult PSF. Multimodal analgesic (MMA) regimens using several drugs and techniques are considered to be necessary for postoperative pain relief.

The mid-transverse process to pleura (MTP) block was first described as a modified paravertebral block in 2017. The local anesthetics (LAs) are administered between the transverse process and the pleura. This results in a LA spread to the dorsal and ventral rami in the paravertebral space through the fenestrations in the superior costotransverse ligament at the level of injection, and frequently to adjacent levels.

Conditions

Mid-Transverse Process Block; Intrathecal Morphine; Idiopathic Scoliosis; Posterior Spinal Fusion

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: DOUBLE

Study Groups

Mid-Transverse Process block (MTP) group

Patients will receive mid-transverse process to pleura (MTP) block after induction of anesthesia.

Group Type: EXPERIMENTAL

Ultrasound-Guided Mid-Transverse Process to Pleura (MTP) Block

Intervention Type: DEVICE

Patients will receive MTP block after induction of anesthesia.

Intrathecal morphine (IM) group

Patients will receive intrathecal morphine in a dose of 12 μg/kg (max 1000 μg) immediately after induction of anesthesia.

Group Type: EXPERIMENTAL

Morphine

Intervention Type: DRUG

Patients will receive intrathecal morphine in a dose of 12 μg/kg (max 1000 μg) immediately after induction of anesthesia.

Interventions

Ultrasound-Guided Mid-Transverse Process to Pleura (MTP) Block

Patients will receive MTP block after induction of anesthesia.

Intervention Type: DEVICE

Morphine

Patients will receive intrathecal morphine in a dose of 12 μg/kg (max 1000 μg) immediately after induction of anesthesia.

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Age ≥ 18 years.
• Both sexes.
• American Society of Anesthesiology (ASA) physical status I-II.
• Idiopathic scoliosis patients undergoing posterior spinal fusion surgery.

Exclusion Criteria

• Patient with morbid obesity (body mass index >40 kg/m2).
• Patients with pre-existing infection at block site.
• Known allergy to study drugs.
• Coagulation disorder.
• History of psychiatric illness.
• Pre-existing neurological deficits.
• Presence of any pre-operative pain or history of chronic pain.
• History of regular analgesic.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Tanta University

OTHER

Sponsor Role: lead

Responsible Party

Mohammed Said ElSharkawy

Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Mohammed S ElSharkawy, MD

Role: PRINCIPAL_INVESTIGATOR

Faculty of Medicine, Tanta University, Tanta, Egypt.

Locations

Tanta University

Tanta, ElGharbia, Egypt

Countries

Egypt

Other Identifiers

36264PR551/2/24

Identifier Type: -

Identifier Source: org_study_id