Efficacy of erector spine plane block in two different approaches to lumbar spinal fusion surgery : a retrospective pilot study

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dc.contributor.authorBirnbaums, Jānis Verners
dc.contributor.authorOzoliņa, Agnese
dc.contributor.authorSolovjovs, Leonids
dc.contributor.authorGlāzniece-Kagane, Zane
dc.contributor.authorNemme, Jānis
dc.contributor.authorLogina, Ināra
dc.contributor.institutionRīga Stradiņš University
dc.date.accessioned2024-04-13T13:15:01Z
dc.date.available2024-04-13T13:15:01Z
dc.date.issued2024-02-14
dc.descriptionPublisher Copyright: Copyright © 2024 Birnbaums, Ozoliņa, Solovjovs, Glāzniece-Kagane, Nemme and Logina.
dc.description.abstractBACKGROUND: Erector spine plane block (ESPB) has been widely used in spinal surgery, although there are variable data about its efficacy. OBJECTIVES: This study aimed to evaluate the efficacy of ESPB in elective lumbar spinal fusion surgery patients with two different surgical approaches. MATERIALS AND METHODS: Retrospectively, 45 elective lumbar transpedicular fusion (TPF) surgery patients undergoing open surgery with different approaches [posterior transforaminal fusion approach (TLIF) or combined posterior and anterior approach (TLIF+ALIF)] were divided into 2 groups: general anesthesia (GA, n  = 24) and general anesthesia combined with ESPB (GA + ESPB, n  = 21). The primary outcome was to analyze the efficacy of ESPB in two different surgical approaches in terms of pain intensity in the first 48 h. Secondary: Fentanyl-free patients and opioid consumption in the first 24 h postoperatively. Comparative analysis was performed (SPSS ® v. 28.0) ( p  < 0.05). RESULTS: Out of 45 patients (27 female), 21 received GA + ESPB and 24 received GA. The average age was 60.3 ± 14.3 years. Chronic back pain before the operation was registered in 56% of patients. ESPB was performed in 17 TLIF and in 4 TLIF+ALIF patients. ESPB significantly reduced pain intensity at rest in both surgical approaches 48 h after surgery ( p  < 0.05). The need for postoperative fentanyl infusion was significantly lower in the group treated with GA + ESPB in both surgical approaches than in those who only received GA (29% vs. 77% in TLIF and 0% vs. 80% in TLIF+ALIF); p  = 0.01 and p  = 0.004. Additionally, we observed that ESPB provides a good analgesic effect for up to 6.8 ± 3.2 h in the TLIF and 8.9 ± 7.6 h in the TLIF+ALIF approaches. Consequently, ESPB reduced the initiation of the fentanyl compared to GA alone, with a mean difference of 3.2 ± 4.2 h in the TLIF subgroup ( p  = 0.045) and 6.7 ± 5.3 h in TLIF +ALIF ( p  = 0.028). Only in the TLIF+ALIF approach, ESPB reduced the total fentanyl consumption compared to those with GA (1.43 ± 0.45 mg/24 h vs. 0.93 ± 0.68 mg/24 h; p  = 0.015). CONCLUSION: ESPB significantly reduced pain at rest after surgery, the number of patients requiring immediate postoperative fentanyl analgesia, and total fentanyl consumption in both surgical approaches, particularly in TLIF+ALIF. However, the application of ESPB does not always provide completely sufficient analgesia.en
dc.description.statusPeer reviewed
dc.format.extent9
dc.format.extent454493
dc.identifier.citationBirnbaums, J V, Ozoliņa, A, Solovjovs, L, Glāzniece-Kagane, Z, Nemme, J & Logina, I 2024, 'Efficacy of erector spine plane block in two different approaches to lumbar spinal fusion surgery : a retrospective pilot study', Frontiers in Medicine, vol. 11, 1330446, pp. 1-9. https://doi.org/10.3389/fmed.2024.1330446, https://doi.org/10.3389/fmed.2024.1330446
dc.identifier.doi10.3389/fmed.2024.1330446
dc.identifier.issn2296-858X
dc.identifier.otherunpaywall: 10.3389/fmed.2024.1330446
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/15431
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85186198394&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofFrontiers in Medicine
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjecterector spine plane block
dc.subjectESPB
dc.subjectlumbar spinal fusion surgery
dc.subjectpain
dc.subjectpostoperative pain
dc.subjectregional anesthesia
dc.subjectultrasound
dc.subject3.2 Clinical medicine
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.subjectGeneral Medicine
dc.titleEfficacy of erector spine plane block in two different approaches to lumbar spinal fusion surgery : a retrospective pilot studyen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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