Effect Of Ultrasound-Guided Single Erector Spinae Block For Postoperative Pain In Lumbar Spine Surgery

Objective:To evaluate the effect of ultrasound-guided single erector spinae plane block(ESP)combined with patient-controlled intravenous analgesia(PCIA)on postoperative analgesia in patients undergoing lumbar spine surgery.Methods:Sixty ASA ?–? patients aged 50–80,with BMI<35 kg/m~2 and scheduled for elective lumbar spine fusion were included in the study.The patients are volunteered to be tested and signed an informed consent.The patients were randomly divided into two groups:single erector spinane block combined with PCIA group(P<0.05)and control group(Cgroup),30 cases in each group.Before induction of anesthesia,the patients were subjected to bilateral ESP block by the same professional anestheist.ESP group received 0.5%ropivacaine 20 ml on each side of the transverse process of lumbar spine and 20 ml normal saline on each side of the transverse process of lumbar spine in the control group.At the end of the operation,PCIA was used for analgesia in both groups.The Numeric rating scale(NRS)pain scores both at rest and coughing on movement were recorded at 2h,4h,6h,8h,12h and 24h postoperatively.The intraoperativepropofol andremifentanilconsumptionwere recorded.Sufentanil consumption and postoperative analgesic requirements were recorded at the first and second 24 h.The time of the first pressing of the analgesic pump,Postoperative recovery and extubation time,postoperative stay in PACU,postoperative discharge time,side effects of opioid drugs such as nausea,vomiting,dizziness and urinary retention were recorded.Results:ComparedwithgroupC,theintraoperativeconsumptionof propofolandremifentanil were decreased significantly in the ESP group(P<0.05).The PCIA cumulative sufentanil consumption of the first 24 h after surgery decreased significantly(P<0.05),but there was no significant difference between the two groups in the PCIAaccumulative sufentanil dosage of the second 24 h(P>0.05).The NRS scores of ESP group decreased significantly at 2 h,4 h,6 h and 8 h rest and exercise(P<0.05),but there was no significant difference between the two groups at 12 h,24 h,48 h(P<0.05).The first time of PCIA press was significantly later in GroupESP(P<0.05).ESP block significantly reduced postoperative consumption of flurbiprofen axetil.The number of patients who required rescue analgesia in the first24 hours,post-operatively,was significantly lower in the E group than group C(P<0.05).In the ESP group,recovery and extubation time,postoperative PACU stay time were significantly shortened(P<0.05).However,there was no significant difference in the postoperative discharge time between the two groups(P>0.05).The degree of satisfaction with Analgesia was significantly increased than those in group C(P<0.05).The incidence of nausea,vomiting and dizziness in ESP group was significantly lower than that in control group(P<0.05).Conclusion:Ultrasound-guided single erector spinae block can significantly reduce the use of opioids during lumbar spine surgery,enhance early postoperative analgesia,reduce adverse reactions,and improve patient satisfaction and comfort.