• BMC anesthesiology · May 2023

    Randomized Controlled Trial

    Erector spinae plane block for perioperative pain management in neurosurgical lower-thoracic and lumbar spinal fusion: a single-centre prospective randomised controlled trial.

    • Daniele Bellantonio, Giuliano Bolondi, Francesco Cultrera, Giorgio Lofrese, Lorenzo Mongardi, Luca Gobbi, Andrea Sica, Carlo Bergamini, Lorenzo Viola, Andrea Tognù, Luigino Tosatto, Emanuele Russo, Domenico Pietro Santonastaso, and Vanni Agnoletti.
    • Anesthesia Unit - Ospedale Bufalini, viale Ghirotti 286, Cesena, FC, 47521, Italy.
    • BMC Anesthesiol. 2023 May 30; 23 (1): 187187.

    BackgroundErector spinae plane block is a locoregional anaesthetic technique widely used in several different surgeries due to its safety and efficacy. The aim of this study is to assess its utility in spinal degenerative and traumatic surgery in western countries and for patients of Caucasian ethnicity.MethodsPatients undergoing elective lower-thoracic and lumbar spinal fusion were randomised into two groups: the case group (n = 15) who received erector spinae plane block (ropivacaine 0.4% + dexamethasone 4 mg, 20 mL per side at the level of surgery) plus postoperative opioid analgesia, and the control group (n = 15) who received opioid-based analgesia.ResultsThe erector spinae plane block group showed significantly lower morphine consumption at 48 h postoperatively, lower need for intraoperative fentanyl (203.3 ± 121.7 micrograms vs. 322.0 ± 148.2 micrograms, p-value = 0.021), lower NRS score at 2, 6, 12, 24, and 36 h, and higher satisfaction rates of patients (8.4 ± 1.2 vs. 6.0 ± 1.05, p-value < 0.0001). No differences in the duration of the hospitalisation were observed. No erector spinae plane block-related complications were observed.ConclusionsErector spinae plane block is a safe and efficient opioid-sparing technique for postoperative pain control after spinal fusion surgery. This study recommends its implementation in everyday practice and incorporation as a part of multimodal analgesia protocols.Trial RegistrationThe study was approved by the local ethical committee of Romagna (CEROM) and registered on ClinicalTrials.gov (NCT04729049). It also adheres to the principles outlined in the Declaration of Helsinki and the CONSORT 2010 guidelines.© 2023. The Author(s).

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