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  • Impact of ultrasound-guided erector spinae plane block on outcomes after lumbar spinal fusion: a retrospective propensity score-matched study of 242 patients—an infographic

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Impact of ultrasound-guided erector spinae plane block on outcomes after lumbar spinal fusion: a retrospective propensity score-matched study of 242 patients—an infographic
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  1. Rajnish K Gupta1,
  2. Ellen M Soffin2 and
  3. Eric S Schwenk3
  1. 1 Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  2. 2 Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA
  3. 3 Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Rajnish K Gupta, Anesthesiology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; raj.gupta{at}vumc.org

https://doi.org/10.1136/rapm-2021-103306

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    Erector spinae plane (ESP) blocks have been described as useful for multiple types of operations in recent years. Soffin et al explore the value of bilateral ultrasound-guided ESP blocks on pain and opioid-related outcomes when they are utilized in combination with a standardized multimodal analgesia care pathway for lumbar fusion.1 The authors used a retrospective propensity score-matched cohort study design to compare patients who did or did not receive ESP blocks. After matching, 242 patients were matched and compared. They did discover a significantly lower 24-hour opioid consumption in the ESP group (30 mg (0.144) vs 45 mg (0.225)). They did not note a significant difference in pain scores in the Post Anesthesia Care Unit (PACU) or on the floor. Length of stay was noted to be about 5 hours shorter in the block group, and fewer patients in the block group required postoperative antiemetics. However, the authors question whether the small reduction in morphine equivalent dose of opioids, the small change in length of stay and the small reduction in postoperative antiemetic use is clinically relevant enough to justify the added effort and risk of erector spinae blocks for lumbar spine surgery when a standard care pathway is employed.

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    Ethics approval

    This study does not involve human participants.

    Acknowledgments

    We would like to acknowledge Jim Snively, artist, of Pittsburgh, PA, for graphic design of this infographic.

    Reference

    1. ↵
      2. Soffin EM ,
      3. Okano I ,
      4. Oezel L , et al
      . Impact of ultrasound-guided erector spinae plane block on outcomes after lumbar spinal fusion: a retrospective propensity score matched study of 242 patients. Reg Anesth Pain Med;133:rapm-2021-103199.doi:10.1136/rapm-2021-103199

    Footnotes

    • Twitter @dr_rajgupta, @ESoffin, @ESchwenkMD

    • Contributors All authors participated in preparation of this infographic, either with editing, design, or finalization.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests RKG and EMS are co-associate editors of Regional Anesthesia and Pain Medicine.

    • Provenance and peer review Commissioned; internally peer reviewed.

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