Niu Jing-Yi, Yang Yi-Di, Ouyang Rui-Ning, Liu Dong, Zhang Quan, Qi Jia-Long, Han Guo-Song, Zheng Ke, Ma Li, Yu Jun-Ma, Yao Deng-Pan
Department of Anesthesiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, 230061, Anhui, China.
Department of Orthopaedics, Bengbu Medical University, Bengbu, 233030, Anhui, China.
Eur J Med Res. 2025 Sep 26;30(1):883. doi: 10.1186/s40001-025-03174-2.
This study aimed to compare the efficacy of liposomal bupivacaine ultrasound-guided erector spinae plane block (ESPB) with wound infiltration (WI) on postoperative analgesia and quality of recovery in patients undergoing lumbar spinal fusion surgery.
Eighty patients scheduled for lumbar fusion surgery were randomized to receive either WI (n = 40) or ultrasound-guided bilateral ESPB (n = 40). Pain intensity in the postanesthesia care unit (PACU) and at 6, 12, 24, 48 and 72 h after surgery was the primary outcome. The secondary outcomes included quality of recovery, intraoperative opioid consumption, use of rescue analgesics within 72 h and postoperative lumbar function. Adverse events were recorded.
Compared with the WI group, the ESPB group demonstrated lower pain scores in the PACU (median [IQR]: 2 [1,2] vs. 2 [2,3]; median difference, -1; 95% confidence interval [CI] -2 to -1; P < 0.001) and at 6 h after surgery (median [IQR]: 2 [1,2] vs. 3 [2,3]; median difference, -1; 95% CI -1 to -1; P < 0.001). There were no significant differences in VAS scores between the two groups beyond 6 h. In addition, the ESPB group had higher Quality of Recovery-15 scale scores at 72 h after surgery (mean ± SD: [119.49 ± 5.01] vs. [116.61 ± 4.33]; P = 0.009). The doses of sufentanil (median [IQR]: 20 [20,22] vs. 25 [23,30]; P < 0.001) and remifentanil (median [IQR]: 680 [560,850] vs 775 [647.5,1005]; P = 0.042) were significantly lower in the ESPB group than those in the WI group. However, there were no differences in the Oswestry Disability Index between the groups at 1 or 3 months after surgery.
For patients undergoing lumbar spinal fusion surgery, compared with WI, ultrasound‑guided ESPB with liposomal bupivacaine provided a slight advantage in improving postoperative analgesia and quality of recovery, and reduced intraoperative opioid consumption. However, these findings probably lack clinical significance.
This study was registered at the Chinese Clinical Trial Registry ( http://www.chictr.org.cn , ChiCTR240084425; Registration Date: May 16, 2024).
本研究旨在比较脂质体布比卡因超声引导下竖脊肌平面阻滞（ESPB）与伤口浸润（WI）对腰椎融合手术患者术后镇痛及恢复质量的效果。
80例计划行腰椎融合手术的患者被随机分为WI组（n = 40）或超声引导下双侧ESPB组（n = 40）。麻醉后恢复室（PACU）及术后6、12、24、48和72小时的疼痛强度为主要结局指标。次要结局指标包括恢复质量、术中阿片类药物消耗量、72小时内急救镇痛药的使用情况及术后腰椎功能。记录不良事件。
与WI组相比，ESPB组在PACU（中位数[四分位间距]：2[1,2] vs. 2[2,3]；中位数差值，-1；95%置信区间[CI]-2至-1；P < 0.001）及术后6小时（中位数[四分位间距]：2[1,2] vs. 3[2,3]；中位数差值，-1；95% CI -1至-1；P < 0.001）的疼痛评分更低。6小时后两组间视觉模拟评分（VAS）无显著差异。此外，ESPB组术后72小时的恢复质量-15量表评分更高（均值±标准差：[119.49 ± 5.01] vs. [116.61 ± 4.33]；P = 0.009）。ESPB组舒芬太尼剂量（中位数[四分位间距]：20[20,22] vs. 25[23,30]；P < 0.001）和瑞芬太尼剂量（中位数[四分位间距]：680[560,850] vs 775[647.5,1005]；P = 0.042）显著低于WI组。然而，术后1或3个月两组间Oswestry功能障碍指数无差异。
对于接受腰椎融合手术的患者，与WI相比，脂质体布比卡因超声引导下ESPB在改善术后镇痛及恢复质量方面有轻微优势，并减少了术中阿片类药物的消耗量。然而，这些发现可能缺乏临床意义。
本研究在中国临床试验注册中心注册（http://www.chictr.org.cn，ChiCTR240084425；注册日期：2024年5月16日）。
