The Impact of Anaesthesia on Hyperalgesia, Testosterone, Cortisol, C-Reactive Protein, and Glucose Levels After Spine Surgery: Prospective Randomised Controlled Trial

Abstract

Abstract Background A large number of spinal deformities with severe pain are treated with complex and traumatic spinal surgeries. The objectives of our study were to test the hypotheses that bilateral erector spinae plane block (BESPB) as a component of combined anaesthesia for spinal surgeries decreases the quantity of opioid analgesic used and reduces hyperalgesia in comparison with general anaesthesia. We additionally proposed the use of serum testosterone, cortisol, C-reactive protein (CRP), and glucose levels as laboratory markers for hyperalgesia. Methods Fifty-two patients who underwent posterior transpedicular fixation of the spine were randomly assigned to either general anaesthesia – control group (CG) – or combined anaesthesia with BESPB – study group (SG). The main outcomes sought were quantity of opioid analgesic perioperatively; hyperalgesia measured with mechanical pain thresholds; and testosterone, cortisol, CRP, and glucose serum levels before and after surgery. Results The quantity of fentanyl and morphine was lower in SG in comparison with CG. There was no difference in mechanical pain thresholds in the SG cohort as opposed to CG, where mechanical pain thresholds were lower on the fifth day after surgery. No difference was found before and after surgery in testosterone, cortisol, CRP, and glucose levels in SG. In the CG, the level of testosterone was significantly lower than baseline; the levels of cortisol, CRP, and glucose were significantly higher than baseline on the fifth day after surgery. Conclusion Bilateral erector spinae plane block as a component of combined anaesthesia for spinal surgeries reduces the quantity of opioid analgesic used and hyperalgesia. Also, we can propose to use the serum testosterone, cortisol, CRP, and glucose levels as the laboratory markers of hyperalgesia.