Effect of Lumbar Erector Spinae Plane Blocks After Lumbar Fusion Surgery: A Randomized Control Trial.

Study design: Randomized control trial.

Objective: To examine erector spinae plane block on a large, comprehensive scale, and investigate the management of postoperative pain and recovery process after lumbar spine surgery using this block.

Summary of background data: Pain management is a key aspect of a patient's care and overall surgical outcome regarding spinal surgery. While most patients have no issues when undergoing spinal surgery, many have pain that will persist postoperation. Our goal was to evaluate the efficacy of erector spinae plane (ESP) blocks before lumbar arthrodesis in helping manage the persisting pains and opioid consumption postsurgery.

Methods: A single-blinded randomized control trial was designed and executed on patients who were to undergo lumbar spine fusion. Before their surgical intervention, patients were randomly assigned to receive the erector spinae plane block or the normal anesthesia/pain management routine.

Results: Of a total of 49 patients, 23 (47%) underwent a spinal block before their respective lumbar spine procedure. Patients with spinal block required fewer supplemental opioids postoperatively (69.9±6.66 vs. 71.7±5.70, P= 0.0002) while reporting less severe pain on VAS pain scoring throughout the first 3 postoperative days (P< 0.0001).

Conclusions: The patient population that received the erector spinae block had significantly lower pain scores on days 1-3 postsurgery, showing that the spine block is effective in helping patients recover from spinal surgery quicker and with less persisting pain. In addition, the number of patients who filled their first opioid prescription was approaching significance, with the ESP block group filling those prescriptions less frequently. ESP blocks appear to be efficacious at reducing pain and opioid consumption in the immediate postoperative period. No additional complications or readmissions were apparent between subgroups.