Eector Spinae Plane Block vs Placebo in ERAS Lumbar Surgery: No Added Analgesic Benefit .
Non-efficacy of ultrasound-guided erector spinae plane block in postoperative analgesia of non-instrumented spine surgery: a randomized, double-blind, controlled trial.
Brain Spine . 2025 Aug 6:5:104379.One hundred patients undergoing non-instrumented lumbar surgery (discectomy or decompression at one or two levels) were randomized to receive an ultrasound-guided bilateral erector spinae plane (ESP) block with levobupivacaine (n=50) or a sham ESP block with normal saline (n=50) in addition to a standardized general anesthetic and multimodal Enhanced Rehabilitation After Surgery (ERAS)-based analgesia protocol. The primary outcome of interest was total morphine consumption (oral and intravenous, expressed as morphine milligram equivalents) over 72 hours postoperatively. Secondary outcomes of interest included daily morphine consumption, cumulative postoperative pain scores over 72 hours, intraoperative sufentanil dose, and 1-month Oswestry Disability Index and back/radicular pain scores. Outcomes were assessed during the first 72 postoperative hours and again at 1 month. Overall, the results of the study revealed no significant difference between ESP block and placebo for total 72-hour morphine use, pain scores, intraoperative opioid use, or 1-month functional and pain outcomes, although there was a non-significant pattern of lower morphine use with ESP on day 0 and higher use from days 1–3 suggestive of a rebound effect. In summary, in the setting of non-instrumented lumbar surgery within an ERAS program, ESP block did not confer additional analgesic or opioid-sparing benefit beyond standardized multimodal analgesia.
Desbloquear el informe ACE completo
Tiene acceso a 4 más artículos GRATUITOS este mes.
Haga clic a continuación para desbloquear y ver este ACE Reports
Desbloquear ahora
Evaluaciones críticas de los últimos ensayos controlados aleatorizados de gran impacto y revisiones sistemáticas en ortopedia
Acceso al contenido del podcast OrthoEvidence, que incluye colaboraciones con el Journal of Bone and Joint Surgery, entrevistas con cirujanos reconocidos internacionalmente y mesas redondas sobre noticias y temas ortopédicos
Suscripción a The Pulse, un boletín quincenal basado en la evidencia y diseñado para ayudarle a tomar mejores decisiones clínicas
Acceso exclusivo a artículos de contenido original, incluidas revisiones sistemáticas propias, y artículos sobre métodos de investigación sanitaria y temas ortopédicos de actualidad
O actualícese hoy mismo y obtenga acceso a todo el contenido de OrthoEvidencepor tan sólo 1,99 $ a la semana.
¿Ya tiene una cuenta? Conectarse
Suscríbase a "El Pulso"
Ortopedia basada en la evidencia directamente a su bandeja de entrada. SUSCRIBIRSE