Related Experiment Video
Updated: Jan 16, 2026
Novel Mini-open Transforaminal Lumbar Interbody Fusion
Published on: June 6, 2025
Postoperative erector spinae plane block does not reduce morphine consumption after lumbar spinal fusion: A
Diana Zamudio1, Laura Fernández1, Andrea Rodríguez1
1Department of Anesthesiology, Alcorcon Foundation University Hospital, Madrid, Spain.
Background:
Postoperative pain management following spinal fusion surgery remains challenging, with opioids being the mainstay of treatment despite their potential adverse effects. The erector spinae plane block (ESPB) has emerged as a promising regional anesthetic technique, but its efficacy in lumbar spinal fusion surgery remains controversial.
Methods:
In this randomized, double-blind, controlled trial, we enrolled adult patients undergoing elective open posterior lumbar arthrodesis between December 2021 and July 2024. Patients were randomized to receive either bilateral ultrasound-guided ESPB with levobupivacaine (ESPB group) or no block (control group) at the end of surgery. The primary outcome was morphine consumption during the first 24 postoperative hours. Secondary outcomes included 48-h morphine consumption, pain scores at different time points, functional recovery milestones, opioid-related side effects and block complications.
Results:
Ninety-three patients completed the study. No significant differences in 24-h (18 mg [IQR 11-28] vs 21 mg [IQR 13-34], P = 0.258) or 48-h morphine consumption were observed between the ESPB and control groups. The ESPB group demonstrated lower pain scores at initial evaluation, 6 h, and 12 h postoperatively, as well as earlier initial mobilization, shorter urinary catheter duration, and reduced incidence of dizziness. Subgroup analyses revealed superior pain control and earlier mobilization with ESPB in transforaminal lumbar interbody fusion procedures and multilevel surgeries. No block-related complications were reported.
Conclusions:
Although postoperative bilateral ultrasound-guided ESPB provided statistically significant improvements in early pain scores and mobilization, these differences did not translate into reduced morphine consumption or meaningful clinical benefits in patients undergoing lumbar spinal fusion surgery. The optimal role of this technique in spine surgery remains to be determined.
Trial Registration:
EudraCT 2020-000135-47.
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