Ultrasound Guided Erector Spinae Plane Block Combined With General Anaesthesia Versus Conventional General Anaesthesia in Lumbar Spine Surgery

Study Overview
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Brief Summary
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Ultrasound guided erector spinae plain block combined with general anaesthesia versus conventional general anaesthesia in lumbar spine surgery, it's hypothesized that combined regional anaesthesia with general anaesthesia in lumbar spine surgery may reduce the anaesthetic requirements, aid in controlled hypotension and improve the perioperative pain management.

Detailed Description
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Primary outcomes: • Anaesthetic requirements: based on entropy monitoring(state and response entropy monitoring and the difference as a measure for adequacy of analgesia) and haemodynamic parameters ( heart rate and mean arterial blood pressure) at the following time intervals: before induction, after induction, after giving either ESP block or multimodal analgesia and starting surgical stimulus, at 30 min intervals, at end of anaesthesia, at eye opening. Secondary outcomes: Stress response measurement based on serum cortisol and blood glucose levels Controlled hypotensive anaesthesia: various drugs required and doses given Intraoperative and postoperative analgesia. Postanaesthesia care unit data concerning recovery.

Official Title
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ERECTOR SPINAE PLANE BLOCK COMBINED WITH GENERAL ANAESTHESIA VERSUS CONVENTIONAL GENERAL ANAESTHESIA IN LUMBAR SPINE SURGERY

Conditions
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Anaesthetic Drugs, Hypotensive Drugs, Perioperative Analgesia

Intervention / Treatment
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* Procedure: Erector spinae plane block
* Drug: Multimodal analgesia


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients undergoing lumbar spine surgery Exclusion Criteria: Coagulation disorders. BMI > 30 or < 18.5. Patients with surgical site infection. Patients with unstable spine integrity like fractures or scoliosis. Hypertensive ,cardiac and diabetic patients.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ultrasound guided erector spinae block and general anaesthesia<br>Ultrasound guided erector spine plane block is done after general anaesthesia and prone positioning | Procedure: Erector spinae plane block<br>* 20 ml local anaesthetic are injected bilaterally on each side of the surgical incision underneath the erector spinae muscle where the dorsal rami pass around the bases of the transverse processes.<br>|
| Active Comparator: Multimodal analgesia with general anaesthesia<br>Multimodal analgesia given with general anaesthesia in form of ketorolac and paracetamol | Drug: Multimodal analgesia<br>* Ketorolac 0.75 mg/ Kg and paracetamol 10 mg/ Kg intravenously<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anaesthetic requirements: | based on entropy monitoring and haemodynamic parameters. | the surgery period |