ERECTOR SPINE PLANE BLOCK WITH GENERAL ANAESTHESIA COMPARED WITH GENERAL ANAESTHESIA WITHOUT REGIONAL COMPONENT FOR SPINE SURGERY: PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

Abstract

Background. Spine surgery is a complex and traumatic surgical intervention that require sufficient anaesthesia supplementation. Erector spine plane block (ESPB) is an effective method of reducing pain intensity, but there is insufficient data on its effect on hemodynamic parameters, blood loss and possible complications.
 Aim. Compare the impact of ESPB as a component of combined anaesthesia with general anaesthesia without regional component on amount of opiates, blood loss and infusion therapy intraoperatively, intensity of pain postoperatively, to study the consequence of the two methods of anaesthesia on hemodynamic parameters, the time of weaning from artificial ventilation and the duration of hospitalization.
 Materials and methods. 151 patients underwent spine surgery. Depending on the method of analgesia, patients were divided into two groups: group 1 – general anaesthesia with ESPB, group 2 – general anaesthesia alone. Primary outcomes: intensity of pain at rest and during movements after surgery 6, 12, 24, 36, 48 hours after surgery, duration of hospitalization, time of weaning from the ventilator. Secondary outcomes: amount of fentanyl used intraoperatively and morphine postoperatively, mean arterial pressure (MAP), heart rate (HR), blood loss, diuresis, and infusion therapy during surgery.
 Results. The intensity of pain at rest and during movement after surgery was significantly lower in group 1. The duration of hospitalization and ventilation was longer in group 2. The amount of opiates intra- and postoperatively was lower in group 1. HR, MBP, blood loss and infusion therapy were higher in group 2. Diuresis did not differ in both groups.
 Conclusion. ESPB as a component of combined anaesthesia reduces the intensity of pain at all stages of observation after surgery, decrease amount of opiates, duration of artificial ventilation and hospitalization. ESPB diminish HR and SBP, minimize blood loss and infusion therapy without affecting diuresis.