Anesthesiology and Reanimation Clinic, Tatvan State Hospital, Bitlis, Turkey.
Department of Anesthesiology and Reanimation, Kocaeli University, Kocaeli, Turkey.
J Anesth. 2021 Jun;35(3):420-425. doi: 10.1007/s00540-021-02920-0. Epub 2021 Mar 22.
Lumbar disc herniation is the most common spinal disorder and various less invasive techniques such as microdiscectomy have been described. However, postoperative pain management in patients undergoing discectomy is still commonly inadequate. Erector spinae plane (ESP) block is a relatively easier technique with lower risks of complications, and can be performed to provide postoperative analgesia for various procedures. The current study aimed to determine the effect of ESP block on postoperative analgesia in patients who underwent elective lumbar disc herniation repair surgeries.
Fifty-four ASA I-II patients aged 18-65 years scheduled for elective discectomy surgery were included in the study. Patients were randomized either to the ESP or control group. Ultrasound-guided ESP block with 20 mL of 0.25% bupivacaine was performed preoperatively in the ESP group patients and a sham block was performed with 20 mL normal saline in the control group patients. All the patients were provided with intravenous patient-controlled analgesia devices containing morphine. Morphine consumption and numeric rating scale (NRS) scores for pain were recorded 1, 6, 12, and 24 h after surgery.
A significantly lower morphine consumption was observed at 6, 12, and 24 h timepoints in the ESP group (p < 0.05 for each timepoint). Total morphine consumption at 24 h after surgery decreased by 57% compared to that of the control group (11.3 ± 9.5 mg in the ESP group and 27 ± 16.7 mg in the control group). NRS scores were similar between the two groups.
This study showed that ESP block provided effective analgesia in patients who underwent lumbar disc herniation surgery.
NCT03744689.
腰椎间盘突出症是最常见的脊柱疾病，已经描述了各种微创技术，如显微椎间盘切除术。然而，接受椎间盘切除术的患者的术后疼痛管理仍然常常不足。竖脊肌平面（ESP）阻滞是一种相对较容易的技术，并发症风险较低，可以用于为各种手术提供术后镇痛。本研究旨在确定 ESP 阻滞对接受择期腰椎间盘突出症修复手术的患者术后镇痛的影响。
纳入了 54 名 ASA I-II 级、18-65 岁的择期椎间盘切除术患者。患者随机分为 ESP 组或对照组。ESP 组患者术前行超声引导下 ESP 阻滞，给予 20mL0.25%布比卡因，对照组患者行假阻滞，给予 20mL 生理盐水。所有患者均给予含有吗啡的静脉患者自控镇痛装置。记录术后 1、6、12 和 24 小时吗啡的消耗量和疼痛数字评分量表（NRS）评分。
ESP 组在术后 6、12 和 24 小时吗啡消耗量明显较低（每个时间点均为 p<0.05）。与对照组相比，术后 24 小时吗啡总消耗量减少了 57%（ESP 组为 11.3±9.5mg，对照组为 27±16.7mg）。两组 NRS 评分相似。
本研究表明，ESP 阻滞为接受腰椎间盘突出症手术的患者提供了有效的镇痛。
NCT03744689。
