Published online Jul 6, 2021. doi: 10.12998/wjcc.v9.i19.5126
Peer-review started: April 13, 2021
First decision: April 23, 2021
Revised: May 6, 2021
Accepted: May 19, 2021
Article in press: May 19, 2021
Published online: July 6, 2021
Processing time: 71 Days and 21.9 Hours
Patients undergoing lumbar spine surgery usually suffer severe pain in the postoperative period.
The erector spinae plane block (ESPB) can anesthetize the ventral and dorsal rami of thoracic nerves and produce an extensive multi-dermatomal sensory block. We proposed that ESPB at a lower thoracic level could improve analgesia effect for patients undergoing lumbar spine surgery.
This study aimed to assess whether bilateral ultrasound-guided ESPB at a lower thoracic level could improve pain control and quality of recovery in patients undergoing lumbar spine surgery.
Patients scheduled to undergo lumbar spine surgery were randomly assigned to two groups: ESPB group (preoperative bilateral ultrasound-guided ESPB at T10 vertebral level) and control group (no preoperative ESPB). The main indicator was the duration to the first patient controlled intravenous analgesia (PCIA) bolus.
In the ESPB group, the duration to the first PCIA bolus was significantly longer, resting and coughing NRS scores at 48 h post operation and sufentanil consumption during the operation were significantly lower, Modified Observer’s Assessment of Alertness/Sedation score within 20 min after extubation was higher, and duration in the post-anesthesia care unit was shorter than those in the control group.
In patients undergoing lumbar spine surgery, ultrasound-guided ESPB at a lower thoracic level improves the analgesic effect, reduces opioid consumption, and improves postoperative recovery.
ESPB at the T10 vertebral level shows benefits over systemic multimodal analgesia in patients undergoing lumbar surgery. The analgesic benefits of ESPB can be attributed to the multimodal analgesia regimen.