Evaluation of the effectiveness of lumbar erector spinae plane block in postoperative analgesia in total hip replacement surgery

Aim: In this study we aimed to investigate the effect of ultrasound-guided lumbar erector spinae plane block (ESPB) on postoperative intravenous analgesic consumption in patients who underwent total hip arthroplasty. Material and Method: A total of 60 patients, aged between 18 and 75 years, with an ASA risk classification of I-II-III, who were scheduled to undergo total hip arthroplasty under general anesthesia in elective conditions, and who indicated their consent by reading and approving the informed voluntary consent form, were included in the study. The patients were randomized into two groups using a simple randomization. The groups were defined as the lumbar ESP block group (n=30) and the control group (n=30) with no intervention. Preoperative demographic data of the patients were recorded. The patients in the block group received the intervention prior to surgery. Both groups were provided with an intravenous PCA device containing fentanyl in the postoperative period, and infusion was administered for 24 hours. Postoperative assessments were made at 0, 6, 12, and 24 hours, comparing VAS scores, fentanyl consumption via PCA, the number of PCA bolus doses, heart rate, systolic and diastolic blood pressure, presence of nausea and vomiting, and the need for additional analgesic doses. Results: Demographic data of both groups were similar. Postoperative VAS scores at 1st, 6th, and 24th hours, as well as the total 24-hour fentanyl consumption via PCA, were found to be lower in the block group. Additionally, the total number of PCA bolus doses over 24 hours was also lower in the block group. There were no statistically significant differences between the groups in terms of heart rate, systolic and diastolic blood pressure, or the presence of nausea and vomiting during follow-up. Conclusion: In our study, it was found that lumbar ESPB reduced the amount of intravenous analgesic consumption and decreased VAS scores during the first 24 hours postoperatively in patients undergoing total hip arthroplasty. We believe that ultrasound-guided lumbar ESPB is an alternative, safe, and effective method for providing analgesia and reducing opioid consumption as part of multimodal analgesia in the postoperative period for patients undergoing hip arthroplasty. We consider it to be an additional technique that can be applied alongside other recommended analgesic methods in the literature.