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Background and Aims Postoperative Delirium (PD), Postoperative Neurocognitive Dysfunction (PND) and Postoperative Chronic Persistent Pain (PCPP) are common in geriatric surgery patients and are associated with postoperative acute pain and opioid consumption. ESP block is used as part of multimodal analgesia in spinal surgery. In the present study, the purpose was to test the hypothesis that ESP block applied to patients undergoing lumbar spinal surgery will reduce PD, PND, and PCPP by reducing the severity of acute pain and opioid consumption.

Methods After obtaining Clinical Research Ethics Committee and patient approvals, 128 patients aged 60 years and above who underwent elective lumbar spinal fusion surgery were randomized with or without ESP block. NRS scores and opioid consumption were recorded in the postoperative 24 hours. PD was assessed with the CAM ICU test for 5 days postoperatively or during hospital stay. PCPP was assessed with the Brief Pain Scoring System 3 months after the spinal surgery. PND was assessed with the MOCA scale administered 3 months later.

Results The number of patients with delirium, cognitive dysfunction, and chronic persistent pain was lower in Group 1 and no statistically significant differences were detected between the groups (p>0.05). In the acute period, NRS scores, and total opioid and rescue analgesic use amounts were significantly higher in Group 2 patients (P<001).

Conclusions Considering that the ESP block reduces postoperative pain intensity and opioid consumption, contributing to the decrease in the incidence of PD, PND, and PCPP, we believe that it is appropriate to use it for analgesia following vertebra surgeries.