Zhang JJ, Zhang TJ, Qu ZY, Qiu Y, Hua Z. Erector spinae plane block at lower thoracic level for analgesia in lumbar spine surgery: A randomized controlled trial. World J Clin Cases 2021; 9(19): 5126-5134 [PMID: 34307563 DOI: 10.12998/wjcc.v9.i19.5126]
Corresponding Author of This Article
Zhen Hua, MD, Professor, Department of Anesthesiology, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongcheng District, Beijing 100730, China. hua1013@163.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Randomized Controlled Trial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jing-Jing Zhang, Teng-Jiao Zhang, Zong-Yang Qu, Yong Qiu, Zhen Hua, Department of Anesthesiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Author contributions: Hua Z and Qu ZY designed the study; Hua Z and Zhang JJ collected the intraoperative data; Zhang TJ and Qiu Y collected the postoperative data; Zhang JJ analyzed the data and wrote the paper.
Institutional review board statement: The protocol was approved by the Beijing Hospital Medical Ethics Committee (2018BJYYEC-011-01).
Clinical trial registration statement: The protocol was registered with the Chinese Clinical Trial Registry at chictr.org.cn (ChiCTR1800015002).
Informed consent statement: An informed consent form was signed by each patient or their legal guardian before enrollment.
Conflict-of-interest statement: None declared.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhen Hua, MD, Professor, Department of Anesthesiology, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongcheng District, Beijing 100730, China. hua1013@163.com
Received: April 13, 2021 Peer-review started: April 13, 2021 First decision: April 23, 2021 Revised: May 6, 2021 Accepted: May 19, 2021 Article in press: May 19, 2021 Published online: July 6, 2021 Processing time: 71 Days and 21.9 Hours
ARTICLE HIGHLIGHTS
Research background
Patients undergoing lumbar spine surgery usually suffer severe pain in the postoperative period.
Research motivation
The erector spinae plane block (ESPB) can anesthetize the ventral and dorsal rami of thoracic nerves and produce an extensive multi-dermatomal sensory block. We proposed that ESPB at a lower thoracic level could improve analgesia effect for patients undergoing lumbar spine surgery.
Research objectives
This study aimed to assess whether bilateral ultrasound-guided ESPB at a lower thoracic level could improve pain control and quality of recovery in patients undergoing lumbar spine surgery.
Research methods
Patients scheduled to undergo lumbar spine surgery were randomly assigned to two groups: ESPB group (preoperative bilateral ultrasound-guided ESPB at T10 vertebral level) and control group (no preoperative ESPB). The main indicator was the duration to the first patient controlled intravenous analgesia (PCIA) bolus.
Research results
In the ESPB group, the duration to the first PCIA bolus was significantly longer, resting and coughing NRS scores at 48 h post operation and sufentanil consumption during the operation were significantly lower, Modified Observer’s Assessment of Alertness/Sedation score within 20 min after extubation was higher, and duration in the post-anesthesia care unit was shorter than those in the control group.
Research conclusions
In patients undergoing lumbar spine surgery, ultrasound-guided ESPB at a lower thoracic level improves the analgesic effect, reduces opioid consumption, and improves postoperative recovery.
Research perspectives
ESPB at the T10 vertebral level shows benefits over systemic multimodal analgesia in patients undergoing lumbar surgery. The analgesic benefits of ESPB can be attributed to the multimodal analgesia regimen.
