AI Article Synopsis

  • The study evaluated the effectiveness of the Erector Spinae Plane Block (ESPB) for improving postoperative quality of recovery (QoR) in patients undergoing transforaminal lumbar interbody fusion (TLIF) or oblique lumbar interbody fusion (OLIF).
  • Patients were divided into two groups: one receiving ESPB and the other as a control, with QoR measured before surgery and on days 1 and 3 after surgery.
  • Results showed no significant difference in QoR-15 scores between the groups, but the ESPB group reported lower pain scores during ambulation and ambulated sooner after surgery, indicating some benefits in pain management rather than overall recovery quality.

Article Abstract

Background: Erector spinae plane block (ESPB) can has been used for analgesia after lumbar spine surgery. However, its effect on postoperative quality of recovery (QoR) remains underexplored in patients undergoing transforaminal lumbar interbody fusion (TLIF) or oblique lumbar interbody fusion (OLIF). This study hypothesized that ESPB would improve postoperative QoR in this patient cohort.

Methods: Patients undergoing TLIF or OLIF were randomized into ESPB (n=38) and control groups (n=38). In the ESPB group, 25 mL of 0.375% bupivacaine was injected into each erector spinae plane at the T12 level under ultrasound guidance before skin incision. Multimodal analgesia, including wound infiltration, was applied in both groups. The QoR-15 score was measured before surgery and 1 day (primary outcome) and 3 days after surgery. Postoperative pain at rest and during ambulation and postoperative ambulation were also evaluated for 3 days after surgery.

Results: Perioperative QoR-15 scores were not significantly different between the ESPB and control groups including at 1 day after surgery (80±28 vs. 81±25, respectively; P=0.897). Patients in the ESPB group had a significantly lower mean (±SD) pain score during ambulation 1 hour after surgery (7±3 vs. 9±1, respectively; P=0.013) and significantly shorter median (interquartile range) time to the first ambulation after surgery (2.0 [1.0 to 5.5] h vs. 5.0 [1.8 to 10.0] h, respectively; P=0.038). There were no between-group differences in pain scores at other times or in the cumulative number of postoperative ambulations.

Conclusion: ESPB, as performed in this study, did not improve the QoR after TLIF or OLIF with multimodal analgesia.

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Source
http://dx.doi.org/10.1097/ANA.0000000000001003DOI Listing

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