Does Erector Spinae Plane Block Decrease Analgesia Requirements After Minimal-Invasive Posterior Transpedicular...

Area of Science:

• Anesthesiology and Pain Management
• Orthopedic Surgery
• Spinal Surgery

Background:

• Minimally invasive posterior stabilization is a common surgical approach for vertebral fractures.
• Effective pain management and reduced opioid consumption are crucial post-operative goals.

Purpose of the Study:

• To evaluate the efficacy of the erector spinae plane (ESP) block in reducing opioid consumption and pain.
• To assess the impact of ESP block on disability, blood loss, and wound healing complications following vertebral fracture stabilization.

Main Methods:

• A prospective, randomized, placebo-controlled, double-blind trial was conducted.
• Patients undergoing minimally invasive posterior stabilization for vertebral fractures were included.
• Primary outcomes included opioid consumption and Visual Analogue Scale (VAS) pain scores within 48 hours.

Main Results:

• The ESP block group showed a significant reduction in morphine consumption (5.357 mg vs. 8.607 mg, P = .004) and VAS scores (3.944 vs. 5.193, P = .046) in the PACU and first 24 hours, respectively.
• Short-term outcomes measured by Patient Reported Outcome Spine Trauma (PROST) scores were significantly improved in the ESP group at day 2 (P = .008) and 4 weeks (P = .036).
• No significant differences were observed in perioperative blood loss or Oswestry Disability Index (ODI) scores between the groups.

Conclusions:

• The erector spinae plane block is effective in reducing opioid requirements by 37.7% and alleviating pain post-operatively.
• ESP block positively influences short-term functional outcomes after minimally invasive spinal surgery for vertebral fractures.
• The study found no significant effect of ESP block on perioperative blood loss or wound healing complications.