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. 2024 Jul;14(6):1786-1792.
doi: 10.1177/21925682231156558. Epub 2023 Feb 9.

Does Erector Spinae Plane Block Decrease Analgesia Requirements After Minimal-Invasive Posterior Transpedicular Stabilization in Patients With Vertebral Body Fracture? A Prospective, Randomized, Double-Blind Controlled Study

Martin Holas  1 , Jakub Hlásny  2 , Radomír Gajdoš  1 , Michal Venglarčík  2 , Peter Šimko  3 , Klaus J Schnake  4 , Peter Merjavy  5   6 , Tomáš Pučan  1 , Juraj Šváč  1 , Robert Nagypál  2 , Tomáš Hríň  1 , Michal Botka  1 , Slavomír Nosál  7 , Soňa Wimmerová  8   9
Affiliations

Does Erector Spinae Plane Block Decrease Analgesia Requirements After Minimal-Invasive Posterior Transpedicular Stabilization in Patients With Vertebral Body Fracture? A Prospective, Randomized, Double-Blind Controlled Study

Martin Holas et al. Global Spine J. 2024 Jul.

Abstract

Study design: Prospective randomized placebo controlled double blind trial.

Objective: To examine the effect of ESP block after minimally invasive posterior stabilization for vertebral fractures on opioid consumption, pain, blood loss, disability level, and wound healing complications.

Methodology: Patients indicated for minimal invasive posterior stabilisation were included to the study. Our primary outcome was the opioid consumption and Visual Analogue Scale (VAS) measured during the first 48 hours. Secondary outcomes used to measure the short-term outcome included Oswestry Disability Index (ODI) and Patient Reported Outcome Spine Trauma (PROST).

Results: In total, 60 patients were included with a 93.3% follow-up. Average morphine consumption during the PACU (Post Anaesthesia Care Unit) period was 5.357 mg in ESP group and 8.607 mg in placebo group (P = .004). Average VAS during first 24 hour was 3.944 in ESP group and 5.193 in placebo group (P = .046). Blood loss was 14.8 g per screw in ESP group and 15.4 g in placebo group (P = .387). The day2 PROST value was 33.9 in ESP group and 28.8 in placebo group (P = .008) and after 4 weeks 55.2 in ESP group and 49.9 in placebo group (P = .036). No significant differences in ODI were detected.

Conclusion: The use of ESP block in minimally invasive spinal surgery for posterior fracture stabilization leads to a significant reduction of opioid consumption during PACU stay by 37.7%. Reduction of opioid consumption was accompanied with lower pain (VAS). We found positive effect of the ESP block on short term outcome scores, but no effect on perioperative blood loss and wound healing.

Keywords: erector spinae plane block; minimal invasive spinal stabilisation; regional anaesthesia; thoracic lumbar spine trauma.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Graph 1.
Graph 1.
Visual Analogue scale.
Graph 2.
Graph 2.
Patient reported outcome for spinal trauma.
Graph 3.
Graph 3.
Oswestry disability index.
See this image and copyright information in PMC

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