Erector Spinae Plane Block for Perioperative Pain Control and Short-term Outcomes in Lumbar Laminoplasty: A Randomized Clinical Trial

Yanwu Jin,1 Shanshan Zhao,1 Jiahui Cai,2 Marcelle Blessing,3 Xin Zhao,1 Haizhu Tan,2 Jinlei Li3 1Department of Anesthesiology, Second Hospital of Shandong University, Shandong University, Jinan, Shandong, People’s Republic of China; 2Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, People’s Republic of China; 3Department of Anesthesiology, Yale University School of Medicine, New Haven, CT, USACorrespondence: Jinlei Li; Haizhu TanDepartment of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, TMP 3, New Haven, CT, 06520-8051, USATel +1 203 785-2802Fax +1 203 785-6664Email jinlei.li@yale.edu; linnanqia@126.comBackground: Spine surgery causes severe pain and can be associated with significant opioid utilization; however, the evidence for opioid-sparing analgesic techniques such as erector spinae plane (ESP) block from controlled studies is limited. We aimed to investigate the analgesic effects of ESP block in lumbar laminoplasty.Methods: In this prospective, double-blind, controlled single-center trial, 62 consecutive elective lumbar laminoplasty patients were randomized into either a control group (Group G, N=32) or a treatment group (Group E, N=30). Group G received general anesthesia and multimodal analgesia, similar to group E, while Group E received additional bilateral ESP block after induction of general anesthesia. The primary outcome was postoperative pain scores for the first 48 h after surgery, and the secondary outcomes analyzed included intraoperative anesthetic usage, perioperative analgesic consumption, return of bowel function and satisfaction for acute pain management indicated by overall benefit of analgesia score (OBAS).Results: Significant differences in pain scores over time were found between the two groups (P=0.010), with Group E patients having significantly lower pain scores than Group G during the first six hours (P=0.000). The opioid consumption in Group G was significantly higher than in Group E both intraoperatively (P=0.000) and postoperatively (P=0.0005). Group E patients had lower intraoperative sevoflurane requirement, improved satisfaction with pain management, and earlier return of bowel function than Group G patients.Conclusion: ESP block is effective in reducing postoperative pain scores and lowering opioid utilization (both intraoperatively and postoperatively), resulting in improved patient satisfaction for pain management in lumbar laminoplasty.Keywords: erector spinae plane block, laminoplasty, spine, perioperative pain, opioid, short-term outcome