Analgesic efficacy of the erector spinae plane block using bupivacaine vs. bupivacaine/magnesium sulphate in patients undergoing lumbar spine surgery: a randomized, double-blinded comparative study

Anaesthesia, Pain & Intensive Care

article

Mohamed Abdelbadie¹ 

[1] Department of Anesthesiology, Surgical ICU and Pain Management, Faculty of Medicine, Beni-Suef University

关键词: Adult;    Analgesia;    Analgesics;    Opioid / therapeutic use;    Bupivacaine;    Humans;    Lumbar spine;    Magnesium sulfate;    Nerve Block;    Pain;    Postoperative / drug therapy;    Pain;    Postoperative / prevention & control;    Paraspinal Muscles;   

DOI  :  10.35975/apic.v26i4.1945

学科分类：社会科学、人文和艺术（综合）

来源: THK

【 摘 要 】

Background & Objectives: Postoperative pain is one of the most troublesome painsfor the surgical patient, andis one of the causes of morbidity and prolonged hospital stay. Opiates and non-steroidal anti-inflammatorydrugs have been routinely used across the world. Recent resurge of regional anesthetic techniques offer someadvantages, especially reduced post-operative nausea and vomiting and less sedation.We compared the efficacy of bupivacaine with a combination of bupivacaine/magnesium sulphate for theErector Spinae Plane (ESP) block in patients for postoperative pain undergoing lumbar spinal fusion undergeneral anesthesia.Methodology: A total of 30 ASA-I and II patients, 20-60 y old, who undergoing lumbar spinal fusion wereenrolled. They were randomly divided into two groups; Group B (n = 15) to receive bupivacaine 0.25 percent,20 mL injected on each side to provide ESP block; and Group BMG (n = 15): to receive 20 mL of 0.25 percentbupivacaine plus 500 mg magnesium sulphate, injected on each side for ESP block.The parameters measured included; the surgery time, non-invasive mean blood pressure during surgery,postoperative heart rate at 1, 6, 12, and 24 h, The time to first request for analgesics time after surgery referredto as the postoperative period (h). Postoperative total analgesic (pethidine needed per 24h) required andpostoperative pain at rest and on moving, measured with VAS (Visual Analogue Scale) at the 1st, 6th, 12th, and24th h.Results: Both at rest and through moving the VAS (Visual Analogue Scale) among both groups. No significantdifference could be seen at the first, sixth, twelfth, and twenty-fourth hours. The time to the first request foranalgesics was significantly prolonged in the Group BMG than the Group B. The total analgesic need aftersurgery was significantly lower in Group BMG than the Group B.Conclusion: The use of a combination of bupivacaine plus magnesium for bilateral erector spinae plane blockafter lumbar spinal fusion surgery is better in terms of prolonged postoperative analgesia and reducing theopioid use as compared to bupivacaine alone in patients undergoing lumbar spinal fusion under generalanesthesia.

【 授权许可】

CC BY-NC