Erector Spinae Plane Block in Spine Surgeries

Study Overview
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Brief Summary
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Aim of this study was to assess the efficacy of erector spinae plane block (ESB) for postoperative pain management in lumbar spine surgery.

Official Title
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Bilateral Ultrasound Guided Erector Spinae Plane Block for Postoperative Pain Management in Lumbar Spine Surgery ( a Controlled Study Trial)

Conditions
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Lumbar Disc Disease

Intervention / Treatment
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* Procedure: erector spinae block for group E


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients American Society of Anesthesiologists physical status (ASA) I and II. Both sexes. Age between 20 to 60 years old. Scheduled for lumbar spine surgeries. Exclusion Criteria: Patients who received long acting opioids preoperatively. Patients with bleeding disorders and coagulopathy. Infection at the injection site. Allergy to local anesthetics. Patients with significant cognitive dysfunction. Patients with diabetic neuropathy. Patients with uncontrolled hypertension or diabetes. Patients with advanced cardiac, respiratory, hepatic or renal disease. Patients with viral hepatitis or HIV.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 60 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: erector spinae block group (E)<br>patients will receive bilateral ultrasound guided erector spinae block before the lumbar spine surgery starts.(20ml of bupivacaine 0.25%) after receiving general anesthesia | Procedure: erector spinae block for group E<br>* . The patient will be placed in the prone position. A high-frequency linear probe or a curved array probe, depending on the BMI of the patient, will be placed in longitudinal alignment, 2-3cm lateral to the vertebral column. The transverse processes of the vertebrae at the level of surgery, the erector spinae muscle, and the psoas muscle will be identified. A 5- or 8-cm 22-G ultrasound needle will be inserted with an in-plane technique in a cephalad-to-caudal direction until bone contact with the top of the transverse process is reached. After slight retraction of the needle, 20ml of bupivacaine 0.25% will be injected behind the erector spinae muscle. The same procedure will be repeated on the contralateral side.<br>|
| No Intervention: control group (C)<br>patients will receive standard general anesthesia for lumbar spine surgery according to hospital protocol. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the postoperative 24 hours morphine consumption | the analgesic effect of erector spine block will be assessed postoperative by numeric rating scale (NRS), if NRS is more than 3 the patient will receive a rescue dose of 5 milligrams of morphine | 24 hours postoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean Blood pressure in mmHg | Measure mean blood pressure of patients postoperative every 4 hours | 24 hours postoperative | 
| Heart rate | Measure heart of the patients postoperative every 4 hours | 24 hours postoperative | 
| Patient satisfaction | Measure patient satisfaction by asking the patient if he is satisfied or not  yes or no | 24 hours postoperative | 
| First time of mobilization to a chair | Measure the time to first mobilization to a chair in minutes | 24 hours postoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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erector spinae block, Lumbar disc surgery