Comparison of bilateral ultrasound guided low thoracic erector spinae block and intravenous patient controlled fentanyl infusion for post-operative analgesia in lumbar surgeries – a randomised control trial.

Majority of the patients undergoing lumbar fusion spine surgery is associated with severe postoperative painespecially in the first post-operative period.1The pain is proportional to the number of operated vertebrae and the invasiveness of the procedure.2 Pain management following spine surgery   largely relies on opioid based protocols, which are associated with adverse effects like nausea, vomiting, pruritis, sedation and risk of long-term habituation and dependence.3 Epidural analgesia is considered gold standard for management of pain, but is associated with its own complication like interference with surgery and intrathecal migration of local anaesthetic drug.4Multimodal approaches to pain management has been demonstrated to allow for improved pain control with less reliance on opioids.5 One of the modes of multimodal analgesia is peripheral nerve blocks and interfascial plane blocks. Erector spinae plane (ESP) block is an interfascial plane blockshown to be effective in most of the thoracic surgeries.Only a few case report and case series are available regarding use of erector spinae block in lumbar surgeries.