Benefits of Erector Spinae Block in lumbar Vertebral Surgical Fixation Procedures; Beyond the Perioperative Analgesic Outcomes

Mousa, Mahmoud Mohamed; Eissa, Saed Abdel Fattah; Salah, Moataz; Farag, Basem

doi:10.21608/pajn.2022.152533.1063

Benefits of Erector Spinae Block in lumbar Vertebral Surgical Fixation Procedures; Beyond the Perioperative Analgesic Outcomes

Document Type : Original Articles

Authors

¹ Department of Neurosurgery, Faculty of Medicine, Helwan University, Egypt.

² Department of Anaesthesia and Pain Management, Faculty of Medicine, Helwan University

³ Department of Neurosurgery, Faculty of Medicine, Tanta University

10.21608/pajn.2022.152533.1063

Abstract

Background: The incidence of chronic pain, or failed back surgery syndrome FBSS, is common after spinal fixation operations. Proper control of acute perioperative pain is thought to decrease its transition to chronic one. Erector spinae (ES) block is a recent paraspinal technique that proved its efficacy after spinal surgery. Herein, we evaluated the effect of ES block on perioperative, short- and intermediate-term outcomes in patients undergoing spinal fixation procedures.
Patients and methods: This prospective study included 124 patients in each of the included two groups; the ES block and control groups. The former underwent an ultrasound-guided ES block before surgery. Our main outcome was functional outcomes along with the incidence of FBSS. Secondary outcomes included operative parameters, perioperative analgesic profile, and patient satisfaction.
Results: All preoperative variables were statistically comparable between the two groups. Although fixation levels did not differ between the two groups, operative time, intraoperative isoflurane consumption, and intraoperative blood loss showed a significant decline in association with the ES block. The same group showed a significant decline in post-operative pain scores, less opioid consumption, and longer time for rescue analgesics. At follow-up, FBSS was markedly decreased in the ES block group, and these patients had markedly improved functional scores.
Conclusion: The beneficial perioperative effects of preemptive ES block were reflected on short- and intermediate-term chronic pain incidence, which in turn was manifested by improved functional scores.

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