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Abstract
Background and aims Inadequate pain control affects morbidity and hospitalization length of stay. Post-operative pain is commonly managed with opioids with important side effect. Recent data has shown that the novel erector spinae plane (ESP) block, can be employed as a safe regional analgesic technique for acute post-surgical and chronic neuropathic pain. The aim of the present study was to investigate the capacity of ESP block to provide successful post-operative pain management undergoing spinal surgery.
Methods 29 patients undergoing open lumbar decompression surgery were randomized in two groups. ESP group (n=12) received ESP block with 0,5% levobubivacain 20 ml. In the control group (n=17) no intervention was performed and postoperative analgesia was achieved with IV morphine plus ketorolac. The primary outcome was represented by postoperative numerical rate scale (NRS) score at various time periods during the first 24 hours following surgery. The secondary outcomes included opioid consumption, rescue analgesia and opioid related side effects. The study protocol was approved by the local review board.
Results Compared with control group, the NRS score of ESP block patients did not show any statistically significant differences in the measured time periods. Twenty-four-hour opioid consumption in group control was significantly higher compared to group ESP (30±2.6 mg and 10±2.08 mg, p<0.001, respectively).
Conclusions Our preliminary findings suggest that ESP block is not inferior compared to opioid in the management of post-operative acute pain, has reduced opioid consumption and may play a key role in the prevention of post-surgical chronic pain.