Erector spinae plane block after lumbar spinal fusion surgery: analgesic efficacy and clinical outcomes

Abstract

Introduction: The erector spinae plane block (ESPB) could be a supplementary technique to reduce pain and morphine consumption following lumbar spinal fusion surgery. We aimed to evaluate its analgesic efficacy and clinical outcomes.

Methods: retrospective cohort study. Adult patients who underwent lumbar spine surgery involving up to 4 level fusion were included. Patients were grouped according to whether they had received erector spinae plane block (ESPB group) or only intravenous morphine (MOR group) for postoperative analgesia. The primary outcome was morphine consumption during the first 48 hours. Secondary outcomes included Visual Analogue Scale (VAS) scores at different times, morphine-related side effects, day of first mobilization, sitting and walking, and hospital length of stay.

Results: 72 patients were included in the study, 37 in the ESPB group and 35 in the MOR group. Morphine consumption during the first 48 hours was significantly lower in the ESPB group (mean 19, SD 15.4) than in the MOR group (mean 35.9, SD 20.4), with a mean reduction of -16.7 mg. VAS scores were lower in the ESPB group at almost all analyzed times. No difference was found in other secondary outcomes except for dizziness and day of first mobilization, which were lower in the ESPB group.

Discussion: Postoperative bilateral ultrasound-guided ESP block can significantly decrease morphine consumption and pain scores during the first 48 postoperative hours after lumbar spine fusion surgery. However, it is not associated to less morphine-related side effects and does not improve recovery or shortens hospital length of stay.