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Title
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A prospective randomized double-blind trial of the efficacy of bilateral lumbar erector spinae plane blocks on the 24h morphine consumption after posterior lumbar inter-body fusion surgery : preliminary results
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Author
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Abstract
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| Objective : This study tested the hypothesis that the 24-h postoperative morphine consumption is significantly lower in patients undergoing posterior lumbar inter-body (PLIF) surgery with lumbar erector spinae plane blocks (ESPB) compared to sham blocks. Background : Spine surgery is associated with considerable postoperative pain, which can be challenging to treat. Locoregional techniques suitable for spine surgery should cover the dorsal root of the spinal nerves at the levels where surgery is performed. The ESPB is a locoregional technique with promising results and was recently described at the thoracic level. Methods : This prospective randomized double-blind multicenter study with preliminary results randomly allocated 20 of the 80 planned adult patients (according to our power analysis), who underwent elective 1 or 2-level PLIF surgery during general anesthesia to one of two groups as follows : bilateral ESPB (20 mL 0.25% levobupivacaine) or bilateral sham block (20 mL NaCl 0.9%). Primary endpoint was 24-h postoperative morphine consumption. Secondary endpoints included 72-h morphine consumption, intraoperative sufentanil dosage, postoperative pain scores at regular time intervals, time to first postoperative mobilisation and the Quality of Recovery-40 survey score. Results : A bilateral ESPB did not decrease morphine consumption in the first 24 hours postoperative [ESPB group : 23.9 (15) mg vs Sham group : 20.8 (17.1) mg, p = 0.731 Likewise, groups did not differ significantly in morphine consumption at 72 hours postoperative, intraoperative sufentanil dosage, postoperative pain scores at regular time intervals, time to first mobilisation and Quality of Recovery-40 survey scores at day one and three postoperative. Discussion and Conclusion : A bilateral ESPB did not prove to be superior to bilateral sham blocks in PLIF surgery regarding reducing morphine requirements, pain scores, PONV and earlier mobilisation in this small preliminary study. More research with larger study populations is necessary to be able to draw definitive conclusions on this subject. |
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Language
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English
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Source (journal)
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Acta anaesthesiologica belgica / Belgische Vereniging voor Anesthesie en Reanimatie; Society for Anesthesia and Resuscitation of Belgium. - Brussel, 1950, currens
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Publication
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Brussel
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2020
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ISSN
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0001-5164
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Volume/pages
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71
:s:[1]
(2020)
, p. 121-128
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ISI
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000641759600017
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