NCT07537647

The Effect of bılateral Erector spına Plan Block on postoperatıve paın ın spınal Surgery

The Effect of Bilateral Erector Spina Plan Block Performed After Lumbar Spinal Stabilization Surgery on Postoperative Patient Recovery and Pain

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 50 (actual)
• Sponsor: Bursa Yuksek Ihtisas Training and Research Hospital · Other Government
• Sex: All
• Age: 18 Years – 65 Years
• Healthy volunteers: Accepted

Summary

Patients undergoing lumbar spinal stabilization surgery may experience severe postoperative pain lasting at least three days. Analgesia after lumbar stabilization surgery is beneficial for early recovery and is therefore necessary. However, traditional opioid-based analgesic techniques are associated with many undesirable effects, including nausea, vomiting, itching, and sedation. Inadequate postoperative pain control also has numerous adverse effects on physiological systems such as the cardiovascular, pulmonary, gastrointestinal, immunological, renal, and hematological systems. Furthermore, inadequate postoperative pain control increases hospital stay, mortality and morbidity, prolongs patient ambulation time, increases patient costs, reduces patient satisfaction, and can lead to chronic postoperative pain. Nonsteroidal anti-inflammatory drugs (NSAIDs), opioid analgesics, and local anesthetics are frequently preferred options for providing postoperative analgesia. In cases where these agents are insufficient to prevent pain, regional techniques are often preferred to reduce the need for opioids. Erector spina plane block (ESPB), a component of multimodal analgesia and one of the regional techniques, was first used by Forero et al. for analgesic purposes in thoracic neuropathic pain and subsequently gained popularity. While ESPB is frequently performed at the thoracic level, its use continues to increase today.

Detailed description

Ultrasound-guided erector spinae plane block (ESPB) that aims for the ventral and dorsal rami of the spinal nerves was recently introduced in spine surgery to treat postoperative pain. ESPB was reported to be effective in scoliosis surgery as it reduced the need for analgesic drugs. Due to its relative technical simplicity, the main advantages postulated for the ESPB are few complications and minimal risk for spinal cord injury.

Conditions

• Erector Spina Plan Block

Interventions

Type	Name	Description
DEVICE	UNDER ULTRASOUND GUİDANCE ESPB BLOCK	In the ESP Block group, with the patient in the prone position, the research anesthesia team will insert a block needle through the skin one level above the surgical level using a linear probe guided by USG. The needle will pass through the trapezius and erector spinae muscles, and upon reaching the transverse process (approximately 2-3 cm deep), a test dose of 0.5-1 mL of 0.9% NaCl will be applied between the erector spinae fascia and the vertebral transverse process to confirm needle placement. After confirmation of fascial opening, a local anesthetic volume of 2 mL per vertebral pressure will be calculated, not exceeding a maximum dose of 2 mg/kg of 0.5% bupivacaine. This total volume will be diluted by half with 0.9% NaCl solution to prepare a 0.25% bupivacaine concentration. The calculated local anesthetic solution will be applied to the erector spinae region for ESPB. The same procedures will be performed on the opposite side.
PROCEDURE	PROCEDURE/SURGERY: ERECTOR SPİNAE (ESP) BLOCK WİTH BUPİVACAİNE	For the ESP Block group, under USG guidance with the patient in prone position, a linear probe will be placed in the parasagittal plane one level above the operative level, and after visualizing the transverse process with an in-plane approach, a 50 mm long block needle will be inserted through the skin. A test dose of 0.5-1 mL of 0.9% NaCl will be administered between the erector spinae fascia and the transverse process of the vertebra to confirm needle placement. After confirming that the fascia has opened, a local anesthetic volume of 2 mL per vertebral pressure will be calculated, not exceeding a maximum dose of 2 mg/kg of 0.5% bupivacaine. This total volume will be diluted halfway with 0.9% NaCl solution to prepare a 0.25% bupivacaine concentration. The calculated local anesthetic solution will be administered to the erector spinae area, and ESPB will be performed. The same procedures will be performed on the opposite side.

Timeline

• Start date: 2024-09-01
• Primary completion: 2025-04-01
• Completion: 2025-05-01
• First posted: 2026-04-17
• Last updated: 2026-04-17

Locations

1 site across 1 country: Turkey (Türkiye)