Bilateral lumbar ultrasound-guided erector spinae plane block versus local anesthetic infiltration for perioperative analgesia in lumbar spine surgery: a randomized controlled trial

BACKGROUND: Lumbar spinal surgery is associated with severe postoperative pain. We examined the analgesic efficacy of bilateral lumbar ultrasound-guided erector spinae plane block (ESPB) with ropivacaine compared with local infiltration. METHODS: Patients undergoing elective lumbar arthrodesis were randomly divided into two groups. Control group received 0.375% ropivacaine 40 mL through the wound, and ESPB group received preoperative bilateral ESPB with 0.375% ropivacaine 40 mL. Primary outcome was postoperative pain intensity at rest using a Numeric Rating Scale (NRS). Secondary outcomes included difference in pain intensity between preintervention and defined timepoints, total amount of opioid analgesic requested by the patients at the same timepoints, the incidence of any adverse event, and the length of hospital stay (LOS) after surgery. RESULTS: Sixty patients were enrolled in the study. After surgery we detected a NRS value of 1.9±1.5 in ESPB group and 5.9±1.6 in control group (P<0.001). About the opioid consumption we found a total sufentanil tablets consumption of 17±6 and 10±3 at 48 hours for control group and ESPB group, respectively (P<0.001). Concerning LOS, 30 (100%) patients in the control group and 22 (73.3%) in ESPB group were discharged after 72 hours (P=0.005). CONCLUSIONS: Bilateral ultrasound-guided ESPB offers improved postoperative analgesia compared with local infiltration in patients undergoing lumbar spinal surgery.