Efficacy of Ultrasound-Guided Erector Spinae Plane Block for Perioperative Pain Control and Short-Term Outcomes in Lumbar Laminoplasty

ABSTRACT Background Erector spinae plane (ESP) block has been reported to provide analgesia in spine surgery in case reports or case series, and there have been no controlled studies to date evaluating its efficacy. We aimed to exam the roles of ESP block in lumbar surgery in a single center randomized control trial by injecting local analgesic into the interfacial plane between the erector spinae muscles and the transverse process under ultrasound guidance. Methods Consecutive elective lumbar surgery patients were randomized into either a control group (general anesthesia only, Group G, N=32) or a treatment group (general anesthesia plus ESP block, Group E, N=30). Several parameters including visual analog scale (VAS, primary outcome), perioperative anesthetics and analgesics usage, indexes of hemodynamics variation, return of bowel function and overall benefit of analgesia score (OBAS) were measured. Results Significant differences in VAS scores over time were found between the two matched groups (P = 0.010). Group E patients had significantly lower pain scores than Group G patients in the early postoperative period within the first 6 hr. Group G and Group E VAS scores peaked at 1 hr and 12 hr, respectively, and the peak pain score in Group G is significantly higher than that of Group E (P = 0.002). In addition, patients who received ESP block had lower perioperative analgesic and sedative medication requirements, improved satisfaction with pain management, more stable hemodynamics, and earlier bowel function return than those using general anesthesia alone. Conclusion Pre-incision bilateral single injection ESP blocks provided effective analgesia perioperatively during lumbar laminoplasty, decreased perioperative anesthesia and analgesia requirement, and accelerated short-term recovery.