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Effects of the Erector Spinae Plane Block on Stress Response and Analgesic Consumption in Patients Undergoing Lumbar

Ramazan Aslanparcasi¹, Erdogan Duran², Veli Fahri Pehlivan²

¹Department of Anaesthesiology and Reanimation, University of Health Sciences, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkiye.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

|April 22, 2026

Abstract

Objective:

To assess the effect of bilateral erector spinae plane block (ESPB) on postoperative analgesic requirements, patient and surgeon satisfaction, postoperative stress response, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) values in patients undergoing lumbar discectomy.

Study Design:

A randomised-controlled trial. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Faculty of Medicine, Harran University, Sanlıurfa, Turkiye, from January to December 2023.

Methodology:

Sixty patients, aged between 18 and 65 years and classified as American Society of Anaesthesiologists (ASA) I-II, who were candidates for single-level lumbar discectomy, were randomly allocated into two groups. Thirty patients received ESPB (Group E), while 30 did not (Group C). Intraoperative vital signs, postoperative analgesic needs, Numerical Rating Scale (NRS) scores, patient and surgeon satisfaction, surgical stress factors, NLR and PLR values, side effects, and complications were recorded. The Kolmogorov-Smirnov Test was used to evaluate the normality of the sample distribution. Independent samples and paired-samples t-tests were used to compare the two groups. The Pearson's chi-square test was used for categorical variables. The Mann-Whitney U test was employed to compare satisfaction scores.

Results:

In Group E, the NLR was significantly lower at the sixth postoperative hour compared to Group C (p = 0.003). Postoperative opioid use and NRS scores were markedly lower in Group E than in Group C, with the time to first bolus administration being significantly longer in Group E.

Conclusion:

The ESPB in single-level lumbar discectomies was associated with a lower NLR, an established indicator of inflammation. Additionally, ESPB provided lower postoperative opioid requirements and pain scores.

Key Words:

Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, Erector spinae plane block, Lumbar discectomy, Postoperative analgesia.

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