Effect of bilateral erector spina plan block on postoperative analgesia in lumbar spinal surgery

Objective: With the increasing number of patients undergoing lumbar spinal surgery, analgesia planning for patients in the postoperative period is also gaining importance. In our study, we aimed to compare the effects of bilateral ESP block at L2-L4 levels on postoperative pain level, opioid consumption in the first 24 hours, and mobilization within the scope of multimodal analgesia in patients undergoing lumbar spinal surgery. Materials and Methods: Our study is a prospective study and includes a total of 102 patients who were planned to undergo lumbar spinal surgery under general anesthesia in elective conditions at Afyonkarahisar Health Sciences University Hospital between 26.09.2021-26.05.2022. The patients were divided into two groups according to the randomized sampling method: ESPB applied (Group Ⅰ; n=51) and not applied (Group Ⅱ; n=51). All patients were administered 1mg/kg tramadol iv for postoperative analgesia approximately 30 minutes before the end of the operation. Intraoperative hemodynamic data of the patients, discharge-hospital stay duration, presence of complications, and VAS scores (during postoperative rest and movement) were recorded. Total tramadol dose, additional analgesic need and first analgesic hour were evaluated. Results: Mean arterial pressures at the end of the operation were significantly lower in the ESPB group than in the Control group. (Figure Ⅶ) (p=0.014). Intraoperative 90th minute and end pulses were found to be significantly lower in the ESPB group than in the Control group. (Figure Ⅷ) (p=0.026, p=0.04) VAS score was found to be significantly lower in the block group than in the control group at all times (Table Ⅲ). The patients' first analgesic needs were found significantly earlier in the control group. (p=0.003) In addition, the time when the patients were first mobilized was significantly earlier in the ESPB group. (Table Ⅳ) (p=0.001) Conclusion: We believe that ESPB block is appropriate to use for analgesia after spinal surgery, as it reduces patient pain scores in spinal surgeries, reduces the total amount of opioids used, lowers VAS values, contributes to the first mobilization hour, and increases patient satisfaction. Keywords: Lumbar spinal surgery, Opioid, ESP block, Postoperative analgesia