The effect of implementation time of erector spina plan block on postoperative anxiety and relief in case of lumbar disc hernioplasti

Objective: In retrospect, there are many studies comparing the effects of general anesthesia and regional anesthesia on patient anxiety. It was observed that anxiety increased in regional anesthesia applications compared to general anesthesia applications. Peripheral block applications are generally preferred to be performed preoperatively in order to determine complications such as motor blockade and local anesthetic (LA) toxicity. Some clinicians prefer to apply peripheral blocks after general anesthesia using a stimulator. No study has been found on whether peripheral block intervention, preoperative awake or post-induction application affects anxiety and recovery quality. In this study, we aimed to compare the effect of erector spina plane block applied preoperatively while awake or after induction on anxiety, recovery and satisfaction in patients who will undergo elective lumbar disc hernioplasty. Materials and Methods: 108 patients aged 18-65 years, ASA I-II-III, who were scheduled for elective single-level lumbar disc hernioplasty, were included in this prospective, randomized controlled, single-blind study. Demographic information of all patients was recorded preoperatively, and STAI-I, STAI-II, which evaluates anxiety, and QoR-40, which evaluates the quality of recovery, were administered. The patients included in the study were divided into two groups: Group P patients received bilateral erector spina plan block in the preoperative unit, and Group I patients received bilateral ESP block at the operation level after repositioning the prone position after anesthesia induction. Pain status was questioned with the NRS score at 1, 4, and 24 hours postoperatively, anxiety was recorded with STAI-I at the 4th hour, and recovery was recorded by applying the QoR-40 questionnaire at the 24th hour. Results: In the comparisons between the groups; there was a statistically significant difference between the groups in terms of the postoperative score of emotional state (p<0.05), the score of Group I patients were higher; It was found that there was no significant difference in the sub-dimensions of physical comfort, physical independence, patient support and pain both preoperatively and postoperatively (p>0.05). Conclusion: The differences in the application time of the erector spina plan block applied for postoperative pain are effective on postoperative recovery. Although the intraoperative block (Group I) does not directly affect anxiety, it contributes positively to the recovery score and the emotional state, which is one of the postoperative recovery parameters. Keywords: Anxiety, Recovery Quality Score (QoR-40), Erector Spina Plan Block (ESP Block)