Bilateral Erector Spinae Plane Blocks for Open Posterior Lumbar Surgery

Area of Science:

• Pain Management
• Regional Anesthesia
• Surgical Recovery

Background:

• Erector spinae plane block (ESPB) is an emerging interfascial plane block for pain management.
• ESPB can target nerves relevant to posterior lumbar surgery.
• This study investigated the effectiveness of pre-operative ESPB in enhancing recovery after posterior lumbar surgery.

Observation:

• Sixty patients undergoing open posterior lumbar decompression were randomized.
• The T12 group received bilateral ESPB with ropivacaine pre-operatively; the control group did not.
• Outcomes included alertness, opioid consumption, ambulation time, and hospital stay.

Findings:

• The T12 ESPB group showed significantly higher alertness (MOAA/S scores) post-extubation compared to the control group (P <0.001).
• Intraoperative and postoperative opioid consumption was significantly lower in the T12 ESPB group (P =0.007 and P =0.003, respectively).
• Patients receiving T12 ESPB ambulated sooner post-surgery (P =0.003), with no significant difference in hospital length of stay (P=0.054).

Implications:

• Pre-operative ESPB at T12 appears effective in improving early recovery after posterior lumbar surgery.
• ESPB can reduce perioperative opioid requirements, contributing to better pain management.
• This technique shows promise for enhancing patient outcomes in lumbar spine surgery.