Comparison of the effects of retrolaminar block (RLB) and erector spinae plane (ESP) block on postoperative recovery quality and pain in lumbar spinal surgery.

BACKROUND

Regional anesthesia techniques are increasingly being utilized as part of multimodal analgesia strategies to reduce postoperative pain and enhance recovery following lumbar spinal surgery. In this study, the effects of erector spinae plane (ESP) block and retrolaminar block (RLB) on postoperative recovery quality and pain were compared.

METHODS

Eighty patients scheduled for elective lumbar surgery were randomly assigned to either the ESP or RLB group. The primary outcome was the quality of recovery at 24 h, assessed using the QoR-40 score. The secondary outcome was total tramadol consumption. Patients' NRS (Numerical Rating Scale) scores, the number of PCA boluses, time to mobilization, time to discharge, and adverse effects were recorded.

RESULTS

There was no significant difference between the two groups in quality of recovery at 24 h postoperatively. Total tramadol consumption and the number of PCA button presses were significantly lower in the ESP group. NRS scores at rest at 12 and 24 h were also significantly lower in the ESP group (p < 0.05). There were no significant differences between the groups regarding the need for additional postoperative analgesia, time to first mobilization, time to discharge, or incidence of adverse effects.

CONCLUSIONS

Although the ESP block demonstrated superiority over the RLB in terms of postoperative pain control and opioid consumption, this advantage was not reflected in the 24-hour recovery quality. Therefore, while the ESP block appears to be more effective in providing analgesia, further studies are needed to compare its impact on functional recovery.