Analgesic efficacy of ultrasound-guided retrolaminar block in truncal surgeries: A narrative review

Postoperative pain management in patients undergoing thoracoabdominal surgery always remains challenging for the anesthesiologist. As a method of pain management, multimodal analgesia is commonly used. In recent years, interfascial plane blocks like erector spine plane block (ESPB), retrolaminar block (RLB), transverse thoracic plane block, and pectointercostal plane block have been increasingly utilized as important components of acute postoperative pain management in truncal surgeries. Here, we reviewed the analgesic efficacy of ultrasound (US)-guided retrolaminar block in patients undergoing truncal surgeries. The primary objective of this review was total opioid consumption within 24 hours of the postoperative period. The secondary objectives were postoperative pain score, time to first analgesic requirement, and adverse effects. All articles relevant to the retrolaminar block were searched in six major databases (PubMed, Embase, Medline, Ovid, PMC, and Google Scholar). A total of 706 records were identified, out of which only 11 kinds of literature were included in this review article, based on our inclusion criteria. The published literature suggests that retrolaminar (RLB) provides more effective analgesia in comparison to the erector spinae block (ESP), is associated with reduced opioid consumption and numeric rating scale (NRS) score, and is not inferior to paravertebral (PVB). There is an evidence that a retrolaminar block can effectively relieve pain during truncal surgery. RLB had a lower rate of complications, was simpler to perform, and required shorter hospital stays.