To Compare the efficacy of bilateral erector spinae block between two groups in spine fusion surgeries

Not yet recruiting

Conditions: Spondylopathy in diseases classified elsewhere,

Registration Number: CTRI/2021/07/034708

Lead Sponsor: pondicherry institute of medical sciences

Brief Summary: Spine surgeries cause excruciating pain in the postoperative period limiting the patientâ€™s ability to ambulate. The pain following surgery is said to last as long as 3-4 days. In order to achieve an early recovery, adequate pain management in the perioperative is essential to avoid any untoward complications. Regional techniques offers the benefit of a better pain control, early recovery of bowel functions, lesser PONV and easier participation in physical therapies comparing systemic analgesics. In line with this, Erector spinae plane block has been in use since 2016 when Forero et al demonstrated its efficacy in mitigating thoracic neuropathic pain. Many research papers were published subsequently stating its varied applications in different surgeries like post thoracotomy pain syndrome, breast surgeries, chronic shoulder pain, ventral hernia repair, abdominal and hip surgeries Siam EM did a comparative study on 30 patients undergoing posterior spine fusion surgeries. The results of the study showed that ESP significantly reduced the stress response, decreased inhalational anaesthetic and also helped in achieving controlled hypotension. Similarly, bilateral erector spinae block was evaluated for postoperative analgesia in lumbar spine surgeries by Singh et al in 2019, were forty patients randomly assigned into two groups and observed all the 20 patients in the control group required additional morphine in the postoperative period when compared to only 9 patients in the ESP group. The pain scores were also higher in the control group compared to the study group. In the same year, the efficacy of ultrasound guided erector spinae block in 60 patients undergoing lumbar spinal decompression surgery as a postoperative analgesic was conducted by yayik. The results showed that the postoperative visual analog scale score was higher at rest and during active movement in the control group when compared to the study group. Also the time at which the first rescue analgesic required was significantly longer in the ESP group. In another study, zhang et al in 2020 found that patients who received preoperative erector spinae block and underwent open lumbar spine surgeries showed enhanced recovery as assessed by MOAA/S score. All these patients had an early ambulation and shorter hospital stay. Eskin et al in 2020 have shown that ultrasound guided erector spinae block for postoperative analgesia in lumbar spine surgeries clearly explains that postoperative pain which was assessed by VAS were constantly lower in study group when compared to control group and hence it results in lowering the first time of rescue analgesic in study group postoperatively for the first 24 hours. In 2019, breebaart conducted a study on efficacy of bilateral lumbar erector spinae block after posterior lumbar fusion surgery and concluded that ESP block is safer in muscle plane which concludes no risk of mechanical nerve injury, reduction in the opioid consumption in ESP block which results in faster recovery and early mobilization postoperatively.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 50

Inclusion Criteria

1)Age group of 18-65 yrs.
2)both genders 3)American society of anaesthesiologist: I /II 4)Patient undergoing primary open posterior spine fusion surgeries under general anaesthesia.

Exclusion Criteria

1)patients BMI >35 2)History of Chronic opioid user 3)History of Patients with Coagulopathy 4)History of Patients with allergy to the study drug.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
1.To assess postoperative pain by using Visual analog score (VAS) for the first 24 hours between erector spinae plane block and conventional general anaesthesia groups in spine surgery patients.	24 hours

Secondary Outcome Measures

Name	Time	Method
1.To compare the hemodynamic parameters between erector spinae plane block and conventional general anaesthesia groups in spine surgery patients.	2.To determine the time for first opioid analgesia requirement in the postoperative period till 24 hours.

Trial Locations

Locations (1): Pondicherry institute of medical science
🇮🇳
Pondicherry, PONDICHERRY, India
Pondicherry institute of medical science
🇮🇳Pondicherry, PONDICHERRY, India
Suresh kumar
Principal investigator
8220123361
murali71095@gmail.com