Ultrasound guided bilateral erector spinae plane block vs caudal epidural block for peri-operative analgesia in lumbar canal stenosis surgeries: A randomized controlled study

Background: Epidural analgesia is considered by many as cornerstone in postoperative analgesia during operations on the lumbar spine.A novel interfacial plane block that is gaining popularity recently which is erector spinae plane block Aim: The goal of this research was to evaluate the analgesic effect of ultrasound guided ESP block versus single-shot ultrasound guided caudal epidural analgesia in lumbar canal stenosis surgeries perioperatively. Patients & methods:This randomized controlled study was done on 56 patients presenting for lumbar canal stenosis surgery in Cairo university hospitals.Patients were randomly assigned equally to receive either ultrasound guided caudal epidural analgesia (Group A) or receive bilateral ultrasound guided lumbar ESP block (Group B) after induction of general anaesthesia.Time to first analgesia request postoperatively and cumulative 24 postoperative opioid consumption were recorded.VAS score was used to assess quality of postoperative analgesia.Results: The mean time to 1st analgesia request in group A (caudal epidural group) was found to be 2.93 + 2.7 hrs while the mean time to 1 st analgesia request in group B was found to be 14.73 + 8.24 hrs.Nevertheless, no variations among two groups were seen after twelve hours following surgery.Conclusion: Bilateral lumbar ESPB looks to be beneficial block for providing excellent perioperative analgesia in lumbar canal stenosis surgery as it decreased opioid consumption significantly compared to US-CEB group.The simplicity and safety of the block make it getting popular.