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Bilateral Erector Spinae Plane Blocks for Open Posterior Lumbar Surgery

Authors Zhang TJ, Zhang JJ, Qu ZY, Zhang HY, Qiu Y, Hua Z

Received 4 February 2020

Accepted for publication 6 March 2020

Published 5 April 2020 Volume 2020:13 Pages 709—717


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Robert B. Raffa

Teng-Jiao Zhang,1,2 Jing-Jing Zhang,1,2 Zong-Yang Qu,1,2 Hong-Ye Zhang,1,2 Yong Qiu,1,2 Zhen Hua1,2

1Department of Anesthesiology, Beijing Hospital, National Center of Gerontology, Beijing, People’s Republic of China; 2Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China

Correspondence: Zhen Hua
Department of Anesthesiology, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Beijing 100730, People’s Republic of China
Tel/Fax +86 10 8513 6409

Purpose: Erector spinae plane block (ESPB) is a newly reported interfascial plane block in pain management, and it can block the nerves exactly in line with the area of the posterior lumbar surgery. The objective of this research was to determine the effectiveness of pre-operative ESPB in enhancing recovery of posterior lumbar surgery.
Patients and Methods: A total of 60 patients undergoing open posterior lumbar decompression surgery under general anesthesia were randomized into two groups. T12 group was performed pre-operatively bilateral ESPB with ropivacaine at the T12 level, but control group did not receive the block. The primary outcome was the Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) score at 10 minutes after extubation. Secondary outcomes included intraoperative sufentanil consumption, postoperative morphine consumption, first time to ambulation after surgery and hospital length of stay after surgery. All participants were followed up to hospital discharge.
Results: The mean (SD) MOAA/S scores at 10 minutes after extubation were 4.2 (95% CI, 4.0 to 4.4), and 3.4 (95% CI, 3.2 to 3.6) in the T12 and control groups (P < 0.001), respectively. Intraoperative sufentanil consumption (P =0.007) and postoperative morphine consumption (P =0.003) were lower in the T12 group than in the control group. Although first time to ambulation after surgery was sooner in the T12 group than in the control group (P =0.003), hospital length of stay was similar (P=0.054).
Conclusion: Pre-operative bilateral ESPB at T12 can enhance recovery after posterior lumbar surgery and reduce perioperative opioid consumption.

Keywords: posterior lumbar surgery, erector spinae plane block, enhanced recovery after surgery, regional anesthesia

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