Wetmore Douglas S, Dalal Sidhant, Shinn Daniel, Shahi Pratyush, Vaishnav Avani, Chandra Akhil, Melissaridou Dimitra, Beckman James, Albert Todd J, Iyer Sravisht, Qureshi Sheeraz A
Hospital for Special Surgery, New York, NY.
Weill Cornell Medical College, New York, NY.
Spine (Phila Pa 1976). 2024 Jan 1;49(1):7-14. doi: 10.1097/BRS.0000000000004581. Epub 2023 Mar 13.
Matched cohort comparison.
To determine perioperative outcomes of erector spinae plane (ESP) block for minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).
There is a paucity of data on the impact of lumbar ESP block on perioperative outcomes and its safety in MI-TLIF.
Patients who underwent 1-level MI-TLIF and received the ESP block (group E ) were included. An age and sex-matched control group was selected from a historical cohort that received the standard-of-care (group NE). The primary outcome of this study was 24-hour opioid consumption in morphine milligram equivalents. Secondary outcomes were pain severity measured by a numeric rating scale, opioid-related side effects, and hospital length of stay. Outcomes were compared between the two groups.
Ninety-eight and 55 patients were included in the E and NE groups, respectively. There were no significant differences between the two cohorts in patient demographics. Group E had lower 24-hour postoperative opioid consumption ( P = 0.117, not significant), reduced opioid consumption on a postoperative day (POD) 0 ( P = 0.016), and lower first pain scores postsurgery ( P < 0.001). Group E had lower intraoperative opioid requirements ( P < 0.001), and significantly lower average numeric rating scale pain scores on POD 0 ( P = 0.034). Group E reported fewer opioid-related side effects as compared with group NE, although this was not statistically significant. The average highest postoperative pain score within 3 hours postprocedurally was 6.9 and 7.7 in the E and NE cohorts, respectively ( P = 0.029). The median length of stay was comparable between groups with the majority of patients in both groups being discharged on POD 1.
In our retrospective matched cohort, ESP blocks resulted in reduced opioid consumption and decreased pain scores on POD 0 in patients undergoing MI-TLIF.
Level 3.
配对队列比较。
确定竖脊肌平面（ESP）阻滞用于微创经椎间孔腰椎椎间融合术（MI-TLIF）的围手术期结局。
关于腰椎ESP阻滞对MI-TLIF围手术期结局及其安全性影响的数据较少。
纳入接受单节段MI-TLIF并接受ESP阻滞的患者（E组）。从接受标准治疗的历史队列中选择年龄和性别匹配的对照组（非E组）。本研究的主要结局是以吗啡毫克当量计算的24小时阿片类药物消耗量。次要结局包括用数字评分量表测量的疼痛严重程度、阿片类药物相关副作用和住院时间。比较两组的结局。
E组和非E组分别纳入98例和55例患者。两组患者的人口统计学特征无显著差异。E组术后24小时阿片类药物消耗量较低（P = 0.117，无统计学意义），术后第0天（POD 0）阿片类药物消耗量减少（P = 0.016），术后首次疼痛评分较低（P < 0.001）。E组术中阿片类药物需求量较低（P < 0.001），POD 0时平均数字评分量表疼痛评分显著较低（P = 0.034）。与非E组相比，E组报告的阿片类药物相关副作用较少，尽管这无统计学意义。术后3小时内E组和非E组术后最高平均疼痛评分分别为6.9和7.7（P = 0.029）。两组的中位住院时间相当，两组大多数患者均于POD 1出院。
在我们的回顾性配对队列中，ESP阻滞可减少MI-TLIF患者POD 0时的阿片类药物消耗量并降低疼痛评分。
3级。
