Effect of ultrasound-guided bilateral erector spinae plane block for postoperative analgesia in patients undergoing multilevel posterior spinal instrumentation.

OBJECTIVE: Patients undergoing spinal fusion surgery suffer from severe postoperative pain. The study aims to investigate the effectiveness of ultrasound-guided erector spinae plane block in alleviating pain following multilevel spinal fusion with instrumentation. PATIENTS AND METHODS: Forty-two patients, who were in classes I-II-III according to the American Society of Anesthesiologists (ASA) classification and were scheduled for lumbar spinal fusion surgery, were randomly divided at a ratio of 1:1 into the erector spinae plane block (ESPB) group and the control group. While an erector spinae plane block was applied before surgery in the ESPB group, no block was involved in the control group. A patient-controlled analgesia pump containing morphine was attached to each patient after surgery. The primary outcome was the amount of morphine used in 24 hours. The secondary outcomes included pain scores and rescue analgesia requirements at different time points. RESULTS: The 24-hour morphine consumption level of the ESPB group was significantly lower than that of the control group (p=0.005). Pain intensity, which was assessed using The Numerical Rating Scale (NRS), was found to be significantly lower in the ESPB group (p<0.05). NRS scores of the two groups were similar at the 12th and 24th hours (respectively, p=0.097 and p=0.157). While rescue analgesia was administered to 71.4% of the patients in the control group, it was administered to 28.6% of those in the ESPB group. The difference between the groups was significant (p=0.005). CONCLUSIONS: Ultrasound-guided bilateral erector spinae plane block in multilevel spinal fusion surgery with instrumentation alleviates severe postoperative pain and reduces opioid consumption.