Changes of Opioid Consumption After Lumbar Fusion Using Ultrasound-Guided Lumbar Erector Spinae Plane Block: A Randomized Controlled Trial. 2021

Lijun Zhu, and Mingcang Wang, and Xiaodan Wang, and Yu Wang, and Lingyang Chen, and Jun Li
Department of Anesthesiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Zhejiang Province, China.

The erector spinae plane block (ESPB) is gaining popularity in lumbar fusion for postoperative pain management. The aim of this study was to investigate the changes of opioid consumption after surgery, the range of cold temperature sensory blockade, pain, and safety. Randomized controlled study. Single center. Patients who were randomized to ESPB with 0.375% ropivacaine (ropivacaine group) and mock ESPB with saline (saline group) and underwent posterior lumbar fusion surgery. The primary endpoint was the total dosage of oxycodone. Secondary endpoints included remifentanil consumption, postoperative pain scores, postoperative adverse events, safety, and range of cold hypoesthesia. Oxycodone consumption in the first 48 hours after surgery was significantly lower in the ropivacaine group than in the saline group (P < 0.05). Remifentanil consumption was significantly lower in the ropivacaine group compared with the saline group during the surgery (0.69 ± 0.03 mg vs. 0.85 ± 0.04 mg, P < 0.05). The areas of cold hypoesthesia were identified in the ropivacaine group after the block, but not in the saline group. Rest and exercise pain scores after surgery were significantly lower in the ropivacaine group than in the saline group (P < 0.05). The overall safety of the ropivacaine group were generally comparable to that of the saline group. The areas of cold hypoesthesia were tested at different time points after ESPB, but the area of sensory loss was not tested, and the recovery of postoperative sensation was not recorded. In addition, we tested only temperature sensation, but not acupuncture pain. Ultrasound-guided lumbar ESPB reduces the amount of analgesics required during and after lumbar fusion and reduces the postoperative Visual Analog Scale pain score.

UI MeSH Term Description Entries
D008159 Lumbar Vertebrae VERTEBRAE in the region of the lower BACK below the THORACIC VERTEBRAE and above the SACRAL VERTEBRAE. Vertebrae, Lumbar
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009407 Nerve Block Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain. Chemical Neurolysis,Chemodenervation,Nerve Blockade,Block, Nerve,Blockade, Nerve,Blockades, Nerve,Blocks, Nerve,Chemical Neurolyses,Chemodenervations,Nerve Blockades,Nerve Blocks,Neurolyses, Chemical,Neurolysis, Chemical
D010098 Oxycodone A semisynthetic derivative of CODEINE. Dihydrohydroxycodeinone,Oxiconum,Oxycodeinon,Dihydrone,Dinarkon,Eucodal,Oxycodone Hydrochloride,Oxycone,Oxycontin,Pancodine,Theocodin
D010149 Pain, Postoperative Pain during the period after surgery. Acute Post-operative Pain,Acute Postoperative Pain,Chronic Post-operative Pain,Chronic Post-surgical Pain,Chronic Postoperative Pain,Chronic Postsurgical Pain,Pain, Post-operative,Persistent Postsurgical Pain,Post-operative Pain,Post-operative Pain, Acute,Post-operative Pain, Chronic,Post-surgical Pain,Postoperative Pain, Acute,Postoperative Pain, Chronic,Postsurgical Pain,Postoperative Pain,Acute Post operative Pain,Chronic Post operative Pain,Chronic Post surgical Pain,Chronic Postsurgical Pains,Pain, Acute Post-operative,Pain, Acute Postoperative,Pain, Chronic Post-operative,Pain, Chronic Post-surgical,Pain, Chronic Postoperative,Pain, Chronic Postsurgical,Pain, Persistent Postsurgical,Pain, Post operative,Pain, Post-surgical,Pain, Postsurgical,Post operative Pain,Post operative Pain, Acute,Post operative Pain, Chronic,Post surgical Pain,Post-operative Pains,Post-surgical Pain, Chronic,Postsurgical Pain, Chronic,Postsurgical Pain, Persistent
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077212 Ropivacaine An anilide used as a long-acting local anesthetic. It has a differential blocking effect on sensory and motor neurons. 1-Propyl-2',6'-pipecoloxylidide,AL 381,AL-381,LEA 103,LEA-103,Naropeine,Naropin,Ropivacaine Hydrochloride,Ropivacaine Monohydrochloride,Ropivacaine Monohydrochloride, (S)-isomer,1 Propyl 2',6' pipecoloxylidide,AL381,LEA103
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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