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Ultrasound-guided erector spinae plane blocks for pain management after open lumbar laminectomy – Lumbar Spinal Stenosis

This article discusses a study that evaluated the analgesic effects of erector spinae plane blocks (ESPBs) combined with multimodal analgesia after open lumbar laminectomy. The study compared the outcomes of patients who received preoperative, bilateral, ultrasound-guided ESPBs with multimodal analgesia to those who received only multimodal analgesia. The primary outcome measure was cumulative opioid consumption at 24 hours, and secondary outcomes included opioid consumption, pain scores, nausea and vomiting requiring antiemetics, and duration of post-anesthesia care unit (PACU) and hospital stay. The results showed that patients who received ESPBs had lower opioid requirements, lower pain scores, fewer instances of postoperative nausea and vomiting, and shorter PACU durations compared to those without ESPBs. In conclusion, the addition of ultrasound-guided, bilateral ESPBs to multimodal analgesia can reduce opioid consumption, pain scores, the need for antiemetic therapy, and the duration of stay in the PACU after open lumbar laminectomy

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised sugical centre on Harley Street UK

Published article

CONCLUSIONS: Ultrasound-guided, bilateral ESPBs, when added to an optimal multimodal analgesia technique, reduce opioid consumption and pain scores, the need for antiemetic therapy, and the duration of stay in the PACU after one or two level open lumbar laminectomy.

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Eur Spine J. 2023 Aug 12. doi: 10.1007/s00586-023-07881-4. Online ahead of print.ABSTRACTPURPOSE: Lumbar spine surgery is associated with significant postoperative pain. The benefits of erector spinae plane blocks (ESPBs) combined with multimodal analgesia has not been adequately studied. We evaluated the analgesic effects of bilateral ESPBs as a component of multimodal analgesia after open lumbar,

Eur Spine J. 2023 Aug 12. doi: 10.1007/s00586-023-07881-4. Online ahead of print.

ABSTRACT

PURPOSE: Lumbar spine surgery is associated with significant postoperative pain. The benefits of erector spinae plane blocks (ESPBs) combined with multimodal analgesia has not been adequately studied. We evaluated the analgesic effects of bilateral ESPBs as a component of multimodal analgesia after open lumbar laminectomy.

METHODS: Analgesic effects of preoperative, bilateral, ultrasound-guided ESPBs combined with standardized multimodal analgesia (n = 25) was compared with multimodal analgesia alone (n = 25) in patients undergoing one or two level open lumbar laminectomy. Other aspects of perioperative care were similar. The primary outcome measure was cumulative opioid consumption at 24 h. Secondary outcomes included opioid consumption, pain scores, and nausea and vomiting requiring antiemetics on arrival to the post-anesthesia care unit (PACU), at 24 h, 48 h, and 72 h after surgery, as well as duration of the PACU and hospital stay.

RESULTS: Opioid requirements at 24 h were significantly lower with ESPBs (31.9 ± 12.3 mg vs. 61.2 ± 29.9 mg, oral morphine equivalents). Pain scores were significantly lower with ESPBs in the PACU and through postoperative day two. Patients who received ESPBs required fewer postoperative antiemetic therapy (n = 3, 12%) compared to those without ESPBs (n = 12, 48%). Furthermore, PACU duration was significantly shorter with ESPBs (49.7 ± 9.5 vs. 79.9 ± 24.6 min).

CONCLUSIONS: Ultrasound-guided, bilateral ESPBs, when added to an optimal multimodal analgesia technique, reduce opioid consumption and pain scores, the need for antiemetic therapy, and the duration of stay in the PACU after one or two level open lumbar laminectomy.

PMID:37572144 | DOI:10.1007/s00586-023-07881-4

The London Spine Unit : most specialised sugical centre on Harley Street UK

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Ultrasound-guided erector spinae plane blocks for pain management after open lumbar laminectomy

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Eur Spine J. 2023 Aug 12. doi: 10.1007/s00586-023-07881-4. Online ahead of print.ABSTRACTPURPOSE: Lumbar spine surgery is associated with significant postoperative pain. The benefits of erector spinae plane blocks (ESPBs) combined with multimodal analgesia has not been adequately studied. We evaluated the analgesic effects of bilateral ESPBs as a component of multimodal analgesia after open lumbar

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