Abstract

Ultrasonography (USG) guided Erector Spinae Plane Block (ESPB) is a novel regional anesthesia technique that local anaesthetics (LA) injection is performed into the fascial plane situated between the transverse process of the vertebra and the erector spinae muscles. It is considered a relatively safe and simple technique to perform. Aims: The present study is aimed to compare the efficacy of USG guided ESP block (ESPB) with incision line infiltration (ILI) in lumbar spine surgeries on post-operative pain control, need for opioids and treatment related side effects. Materials and Methods: The present study was a prospective, randomized, double-blinded study. This Study was conducted from September 2019 to April 2022 at Department of Anaesthesia in Orthopedic Operation Theatre complex of ESIC PGI-MSR & ESI Medical College, Joka. Forty males, aged 18-60 years, with an American Society of Anesthesiologists physical status I/II, scheduled for elective lumbar decompression surgery, were divided into two equal groups. Group E included 20 patients and group I included 20 patients. Group E received bilateral ultrasound-guided ESPB with 20 mL Inj. Bupivacaine (0.25%) and Group I received 20 ml Inj. Bupivacaine (0.25%) at incision site at the end of the surgical procedure. The primary outcome was comparison of the 24-hour postoperative quality analgesia in terms of Numeric Pain Rating Scale (NRS) score. The secondary outcomes were time to first analgesic requirement, opioid consumption and adverse events. Result: We found that quality of analgesia in terms of Numeric Pain Rating Scale (NRS) in first 24h and duration of analgesia was statistically significant in two groups. Occurrence of complications such as post-operative nausea and vomiting (PONV), hematoma, bleeding or allergic reactions were not statistically significant in two groups. Conclusion: Erector Spinae Plane Block can provide adequate analgesia and has an opioid-sparing effect than incision line infiltration. It was found that quality of analgesia in terms of NRS in 1st 24h and duration of analgesia was much less in ESB than ILI which was statistically significant. Occurrence of complications such as post operative nausea and vomiting (PONV), hematoma, bleeding or allergic reactions were not statistically significant in two groups

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