Periacetabular Osteotomy Multimodal Pain Control Using Erector Spinae Plane versus Epidural Catheter: A Retrospective...

Area of Science:

• Anesthesiology
• Orthopedic Surgery
• Pain Management

Background:

• Periacetabular osteotomy is a key treatment for developmental hip dysplasia.
• Traditional epidural analgesia for this procedure can cause motor/sensory deficits and hypotension, delaying recovery.
• Erector spinae plane block is an alternative regional anesthesia technique with a favorable safety profile.

Purpose of the Study:

• To retrospectively compare the efficacy and safety of erector spinae plane block versus epidural analgesia for periacetabular osteotomy.
• To evaluate pain scores, opioid consumption, and adverse events in patients undergoing periacetabular osteotomy.

Main Methods:

• Retrospective review of 146 patients (73 epidural, 73 erector spinae plane block) undergoing periacetabular osteotomy.
• Data collected included pain scores, opioid consumption (morphine equivalents), complications, and discharge parameters.
• Statistical analysis included Welch's t test, Glass's δ, and Fisher exact tests (α = 0.05).

Main Results:

• No significant differences in patient demographics, catheter duration, or length of stay were observed.
• Erector spinae plane block patients required fewer morphine equivalents postoperatively (P < 0.001) but reported slightly higher pain on POD 0 (P = 0.008).
• The epidural group experienced significantly more weakness (16.44% vs 4.11%), numbness (39.73% vs 9.59%), and hypotension (10.96% vs 1.37%) (all P < 0.05).

Conclusions:

• Erector spinae plane block is an effective pain management strategy for periacetabular osteotomy.
• It leads to reduced opioid requirements and fewer adverse effects, including numbness, hypotension, and weakness, compared to epidural analgesia.
• Erector spinae plane block represents a valuable option for multimodal pain management in periacetabular osteotomy.