Clinical trial NCT06693141: Effects of Erector Spinae Plane Block and Intrathecal Morphine Administration on Intraoperative Sevoflurane Consumption
Official title: Comparison of the Effects of Erector Spinae Plane Block and Intrathecal Morphine Administration on Intraoperative Sevoflurane Consumption in Disc Surgeries
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Postoperative Pain
Anesthesia
Keywords: Erector Spinae Plane block
Intrathecal morphine
Lead sponsor: Ankara Etlik City Hospital
Sponsor class: OTHER_GOV
First posted: 2024-11-18
Enrollment: 99
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients operated for single level and non-recurring lumbar disc herniation.

Brief summary: In our study, the investigators aimed to compare the intraoperative sevoflurane consumption and postoperative analgesic needs of patients who underwent lumbar disc herniation surgery and received either ESP block or ITM in the preoperative period with a control group.

Detailed description: The amount of volatile anesthetic agents used for anesthesia maintenance can be significantly reduced with potent and long-acting analgesic interventions administered during the preoperative period. Such interventions enable the maintenance of anesthesia with more optimal levels of agents during surgery, providing significant advantages in terms of both patient safety and cost.

Studies have recommended multimodal analgesia approaches involving the Erector Spinae Plane (ESP) block and intrathecal morphine (ITM) injection for various surgical procedures. These two methods, through different mechanisms of action, not only reduce intraoperative anesthetic agent consumption but also play a critical role in postoperative pain management. Although studies have investigated the effects of ESP block and ITM injection on intraoperative volatile anesthetic consumption, there is limited research directly comparing their impacts on volatile anesthetic consumption and postoperative analgesic requirements.

In our study, we aimed to compare the intraoperative sevoflurane consumption and postoperative analgesic needs of patients who underwent lumbar disc herniation surgery and received either ESP block or ITM in the preoperative period with a control group.

Eligibility criteria: Inclusion Criteria:

* Patients aged over 18 years
* Patients receiving general anesthesia
* Patients with an ASA score of I-II
* Patients undergoing elective surgery for single-level lumbar disc herniation
* Patients who provided informed consent after being informed

Exclusion Criteria:

Patients who did not provide informed consent after being informed

* Patients over 65 years of age
* Patients with an ASA score of III or higher
* Patients with recurrent lumbar disc herniation (LDH)
* Patients undergoing surgery for multi-level LDH
* Patients with a body mass index (BMI) of 30 or higher
* Patients with allergies to morphine or bupivacaine
* Patients with major cardiac, respiratory, hepatic, renal, neurological, or psychiatric diseases
* Patients with a history of alcohol or substance abuse
* Patients with a local infection at the injection site
* Patients with bleeding diathesis
* Patients with a history of anticoagulant medication use
* Patients with contraindications to spinal or regional anesthesia

Primary outcomes:
measure: Intraoperative Sevoflurane consumption
timeFrame: 60 minutes after anesthesia induction
Secondary outcomes:
measure: Rescue analgesic consumption
timeFrame: 2 hours postoperatively
measure: Rescue analgesic consumption
timeFrame: 4 hours postoperatively
measure: Rescue analgesic consumption
timeFrame: 8 hours postoperatively
measure: Rescue analgesic consumption
timeFrame: 12 hours postoperatively
measure: Rescue analgesic consumption
timeFrame: 24 hours postoperatively
Other outcomes:
Locations:
city: Ankara
country: Turkey
facility: Ankara Etlik City Hospital
state: Varlık Mahallesi, Halil Sezai Erkut Caddesi Yenimahalle
Study officials:
References:
citation: Yorukoglu HU, Icli D, Aksu C, Cesur S, Kus A, Gurkan Y. Erector spinae block for postoperative pain management in lumbar disc hernia repair. J Anesth. 2021 Jun;35(3):420-425. doi: 10.1007/s00540-021-02920-0. Epub 2021 Mar 22.
citation: Lal A, Singh MK, Kanaujia SK, Mishra NK, Singh BP, Singh GP. Comparison of Intrathecal Morphine Versus Erector Spinae Plane Block for Perioperative Analgesia in Patients Undergoing Lumbar Spine Surgery: A Randomized Control Trial. Cureus. 2024 Jul 17;16(7):e64775. doi: 10.7759/cureus.64775. eCollection 2024 Jul.
citation: Nashibi M, Sezari P, Safari F, Teymourian H, Asgari S, Mottaghi K. The effect of erector spinae plane block on the use of anesthetic medications in lumbar spine surgery. Agri. 2023 Oct;35(4):228-235. doi: 10.14744/agri.2022.48992.