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Erector Spinae Plane Blocks for Circumferential Lumbar Spinal Fusion: Retrospective Cohort Study – Lumbar Fusion

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The article discusses the efficacy of erector spinae plane (ESP) blocks for postoperative pain control and its impact on opioid consumption in patients undergoing circumferential lumbar spinal fusion. The study found that patients who received an ESP block had shorter hospital stays and lower opioid requirements in the first 48 hours after surgery compared to those who did not receive the block. Visual analog scale scores did not significantly differ between the two groups, except for on postoperative day 4 and at the 12-month follow-up. This study provides further evidence that ESP blocks are a useful adjunct for multimodal pain control in patients undergoing lumbar spine fusion procedures

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised day surgery hospital in the world

Published article

CONCLUSIONS: The use of ESP blocks for patients undergoing 1- or 2-level circumferential fusion via an anterior lumbar interbody fusion with concomitant posterior open procedures was associated with decreased postoperative inpatient opioid requirements and LOS. This cohort study supports the growing body of evidence that ESP blocks are a useful adjunct for multimodal pain control.

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Int J Spine Surg. 2023 Aug 25:8528. doi: 10.14444/8528. Online ahead of print.ABSTRACTBACKGROUND: Circumferential lumbar spine fusions are extensive procedures that involve accessing the lumbar spine from multiple approaches. These surgeries often make postoperative pain control challenging, and efforts have been made to find alternative methods of analgesia that do not rely solely on opioids.,

Int J Spine Surg. 2023 Aug 25:8528. doi: 10.14444/8528. Online ahead of print.

ABSTRACT

BACKGROUND: Circumferential lumbar spine fusions are extensive procedures that involve accessing the lumbar spine from multiple approaches. These surgeries often make postoperative pain control challenging, and efforts have been made to find alternative methods of analgesia that do not rely solely on opioids. The use of erector spinae plane (ESP) blocks has been found to be effective in controlling pain while decreasing narcotic requirements in patients undergoing thoracolumbar spine surgery. The purpose of this study is to evaluate the efficacy of ESP blocks for postoperative pain control and its effect on opioid consumption in patients undergoing circumferential lumbar spinal fusion.

METHODS: A retrospective review was performed on patients undergoing 1- or 2-level elective anterior lumbar interbody fusion with open posterior decompression and posterolateral fusion. An analysis was performed to determine the effect of ESP blocks on hospital length of stay (LOS), pain scores using the visual analog scale, and opioid consumption using morphine milligram equivalents.

RESULTS: 144 patients were included in the cohort analysis, of whom 36 patients received a preoperative ESP block and 108 did not. Demographic data, comorbidities, and number of levels fused were equally distributed between groups. Patients who received an ESP block had shorter LOS (3.0 vs 4.0 days, P = 0.005) and lower cumulative morphine milligram equivalent in the first 48 hours after surgery (123.7 vs 141.2, P = 0.05). Visual analog scale scores did not significantly differ between patients group except for on postoperative day 4 and at 12-month follow-up.

CONCLUSIONS: The use of ESP blocks for patients undergoing 1- or 2-level circumferential fusion via an anterior lumbar interbody fusion with concomitant posterior open procedures was associated with decreased postoperative inpatient opioid requirements and LOS. This cohort study supports the growing body of evidence that ESP blocks are a useful adjunct for multimodal pain control.

LEVEL OF EVIDENCE: 3 CLINICAL RELEVANCE: The data and results of this study provide clinical evidence supporting the use of ESP blocks in patients undergoing circumferential lumbar spine fusion procedures.

PMID:37625857 | DOI:10.14444/8528

The London Spine Unit : most specialised day surgery hospital in the world

Read the original publication:

Erector Spinae Plane Blocks for Circumferential Lumbar Spinal Fusion: Retrospective Cohort Study

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Int J Spine Surg. 2023 Aug 25:8528. doi: 10.14444/8528. Online ahead of print.ABSTRACTBACKGROUND: Circumferential lumbar spine fusions are extensive procedures that involve accessing the lumbar spine from multiple approaches. These surgeries often make postoperative pain control challenging, and efforts have been made to find alternative methods of analgesia that do not rely solely on opioids.

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