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

BMC Anesthesiology

Research

Domenico Pietro Santonastaso¹  GiulianoBolondi¹  Andrea Sica¹  Luca Gobbi¹  Daniele Bellantonio¹  Lorenzo Viola¹  Carlo Bergamini¹  Emanuele Russo¹  Vanni Agnoletti¹  Andrea Tognù²  Luigino Tosatto³  Giorgio Lofrese³  Francesco Cultrera³  Lorenzo Mongardi³ 

[1] Anesthesia Unit - Ospedale Bufalini, viale Ghirotti 286, 47521, Cesena, FC, Italy;Anesthesia Unit, Istituto Ortopedico Rizzoli, Via Nazionale Ponente 5, 44011, Argenta, FE, Italy;Neurosurgery Unit - Ospedale Bufalini, viale Ghirotti 286, 47521, Cesena, Italy;

关键词: Early recovery after surgery;    Erector spinae plane block;    Neurosurgery;    Postoperative pain;    Regional anaesthesia;    Spine;    Spinal fusion;   

DOI  :  10.1186/s12871-023-02130-z

 received in 2022-12-02, accepted in 2023-05-09,  发布年份 2023

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© The Author(s) 2023

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