A preoperative nerve block used in combination with other medications can reduce the need for opioids to manage pain following spinal surgery, UT Southwestern Medical Center researchers found. The findings, published in European Spine Journal, suggest a way to lessen the reliance on opioids to reduce postoperative pain and help patients become ambulatory sooner.
Open lumbar spine surgery patients who received a bilateral erector spinae plane block (ESPB) as part of a multimodal analgesic regimen had a significant reduction in both pain scores and opioid consumption in the first 24 to 48 hours after surgery, compared with those who were treated just with a multimodal analgesic approach, according to the study. These patients also required less medication to control nausea or vomiting and had shorter recovery room stays.
The retrospective study compared postoperative measures of 50 patients who underwent open lumbar laminectomy for spinal stenosis. Half received an ESPB along with standardized multimodal analgesia, and half received multimodal analgesia alone. ESPBs are administered just prior to surgery through an ultrasound-guided injection.
At 24 hours post-surgery, opioid requirements among ESPB patients were reduced by about half compared with non-ESPB patients and remained lower at the 48-hour mark. Pain scores in the post-anesthesia care unit (PACU) and through the second day after surgery were also significantly lower, and time in the PACU was reduced by about 30 minutes.
