Towards the efficacy of erector spinae plane block in lumbar spinal fusion

Abstract

AIM: This study aimed to assess the efficacy and safety of the erector spinae plane block (ESP-block) in lumbar spinal fusion in the perioperative period.
 MATERIALS AND METHODS: This prospective randomized study included 200 patients aged 4565 years undergoing decompression and lumbar spinal fusion. All the patients were divided into three groups depending on the anesthesia method. The first group received general anesthesia in combination with a single bilateral ESP-block; the second group received general anesthesia in combination with a prolonged bilateral ESP-block; the third (or, control) group was given general anesthesia. The parameters of intraoperative hemodynamics, the postoperative pain according to the visual analog scale, the need for opioid analgesics during and after surgery, the incidence of postoperative nausea and vomiting, and other anesthesia-induced adverse reactions were assessed.
 RESULTS: Patients who received the single bilateral ESP-block have exhibited adequate pain relief, leading to minimal opioid analgesic consumption in the early postoperative period. However, prolonged ESP-block with bilateral catheters is the most efficacious postoperatively, and patients hardly needed narcotic analgesics and featured a low incidence of postoperative nausea and vomiting (hazard ratio: 0.32; 95% confidence interval: 0.2130.464; р 0.001).
 CONCLUSION: The bilateral ultrasound-assisted ESP-block in lumbar decompression and spinal fusion ensures adequate pain relief both intra- and postoperatively, resulting in a reduced need for opioid analgesics and minimizing their related incidence of adverse reactions.