Efficacy and Safety of Ultrasound-Guided Erector Spinae Plane Block at Different Injection Depths for Percutaneous Kyphoplasty: A Randomized Controlled Trial.

Study Summary

120 elderly patients with osteoporotic vertebral compression fractures (OVCFs) undergoing elective percutaneous kyphoplasty (PKP) were randomized to receive deep erector spinae plane block (ESPB), superficial ESPB, or combined deep and superficial ESPB, with all patients receiving intravenous esketamine 0.125 mg/kg preoperatively. The primary outcomes of interest were intraoperative pain measured using the visual analogue scale (VAS) at key procedural stages and cumulative intraoperative pain expressed as the area under the VAS curve (area under curve [AUC] 0-4). Secondary outcomes included postoperative VAS scores, mean arterial pressure, heart rate, sensory block onset, rescue analgesia requirements, and adverse reactions. Outcomes were assessed intraoperatively and at 6, 12, and 24 hours postoperatively. Overall, the results of the study revealed that combined deep and superficial ESPB produced the lowest cumulative intraoperative pain, required fewer rescue analgesic administrations, and provided more stable haemodynamics than either single-depth technique. These findings suggested that targeting both superficial and deep tissue planes provided more balanced analgesia throughout PKP without increasing common adverse reactions.