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"A COMPARATIVE STUDY OF ULTRASOUND-GUIDED ERECTOR SPINAE BLOCK AND LOCAL INFILTRATION FOR LUMBAR SPINE FUSION SURGERIES”

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Dr. Busetty Prithvi Raj, Dr. Maheswari. R, Dr. Chaitanya Jakkam, Dr. Gadde Chandra sekhar, Dr. Valluri Anil Kumar, Dr. K. Krishna Chaithanya
» doi: 10.53555/ejmcm/2024.11.05.12

Abstract

Background and Objectives: Spinal surgeries are generally associated with intense pain. ESPB is one of the newer interfascial techniques with potential applications. We describe our adaptation of the ESPB to provide intraoperative and post operative analgesia as part of a multimodal opioid-sparing regimen in patients undergoing single level lumbar spine fusion surgery. Our trial aimed to assess the effectiveness of USG ESPB in lumbar spine surgeries, evaluating factors such as hemodynamic stability, NRS scores, total opioid consumption, and the amount of rescue analgesia required. METHODOLOGY We conducted a study on 40 ASA I and II patients undergoing single level lumbar spine fusion surgery with general anesthesia.Among these, 20 patients were provided with postoperative analgesia through USG ESPB administered after the surgery (group B). The remaining 20 patients received local infiltration (group C) both groups will have tramadol as rescue analgesia . All patients in both groups were subjected to a consistent standard anesthesia regimen during the surgery. Subsequently, we closely monitored all patients in both groups for a 24-hour postoperative period. Hemodynamic parameters including HR, SPO2, SBP, and DBP were meticulously recorded at specific intervals: 20 minutes, 40 minutes, 1 hour, 3 hours, 6 hours, 12 hours, 18 hours, and 24 hours after the surgical procedure. RESULTS We had observed that there was no significant difference observed with respect to vital parameters in between the groups. In our study, there was no significant difference noticed between the groups with respect to demographic data. There was significant reduction in cumulative fentanyl consumption in group B and there was significant difference noticed in NRS scores recorded at different intervals between the two groups of adverse effects like PONV and sedation were lesser in group B as compared to group C.Number of patients satisfied with postoperative pain management were significantly more in group B compared to group C. We did not experience any complications or unexpected effects related to ESPB during the study. Additionally, when evaluating patient comfort using the Bruggmen comfort scale, Group B demonstrated significantly higher comfort levels compared to Group C. Furthermore, we identified significant differences in hemodynamic parameters between the two groups. Conclusion: In our study, we observed reductions in intraoperative opioid usage and postoperative NRS scores among patients who received ESPB. Additionally, the necessity for supplementary analgesia was notably diminished in those who received ESPB. Consequently, ESPB emerges as a promising approach to alleviate postoperative pain, and potentially serves as an integral component of a comprehensive analgesic strategy for individuals undergoing lumbar spine fusion surgeries.

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