Comparison of the postoperative effects of the erector spina plane block and local infiltration analgesia in patients operated with lumbotomy surgery incision

Background and aim: We will compare the intraoperative and postoperative opioid consumption and NRS scores of the LIA or ESP block methods that we will apply preemptively in patients operated on with lumbotomy surgical incision. Methods: Ethics committee approval was obtained from the patients. Sixty patients who were scheduled for surgery with lumbotomy surgical incision were included in the study. Our patient groups were between ASA I-III, 18-75 years old. The study was carried out prospectively, randomized controlled, double-blind. Standard anesthesia induction was applied. ESP block (30) and LIA (30) were applied preemptively to the groups. In addition, analgesia was planned with intraoperative remifentanil, postoperative morphine and paracetamol. Postoperative morphine and additional analgesia consumption, NRS scores, hemodynamic parameters and complications were recorded for 48 hours. Results: There was no difference between the groups in terms of demographic and hemodynamic data. Intraoperative ESPB and LIA group remifentanil consumption average was measured as 455 ± 165.23 mcg and 296.67 ± 110.59 mcg, respectively. Statistical difference was observed (p = 0.001). The postoperative ESPB group drug consumption and NRS score averages were significantly lower at all times (p = 0,01) (Morphine 41.93 ± 14.47 mg vs 57.23 ± 15.5 mg, Paracetamol 2.1 ± 1.06 g vs 4.27 ± 1.14 g). The mean of additional analgesic intake times were significant as 10.6 ± 8.1 hours in the LIA group and 19.33 ± 8.87 hours in the ESPB group. Patient satisfaction questionnaire was significant in favor of ESPB (p = 0,05). Conclusion: It has been shown that intraoperative LIA method is more effective in terms of remifentanil consumption in the control of pain that occurs in operations performed with flank incision, but ESPB method provides longer and effective pain control in postoperative follow-ups. Keyword: Flank (lumbotomy) incision, erector spina plane block, local infiltration analgesia,