Fluoroscopic-guided erector spinae plane block for spine surgery

Kim, Eric; Alshoubi, Abdalhai

doi:10.4103/sja.sja_694_21

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…Ultrasound-guided ESPB allows clinicians and patients to avoid ionizing radiation and is recommended in particular populations, such as obstetrics or pediatrics (20). The aforementioned method allows for more precise targeting and real-time monitoring of the extent of drug diffusion during injection.…”

Section: Ultrasound-guided Espbmentioning

confidence: 99%

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Ultrasound‑guided erector spinae plane block in posterior lumbar surgery (Review)

Deng,

Huang,

2024

Biomed Rep

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The erector spinae plane block (ESPB) is a novel fascial planar block technique, which is used to reduce postoperative pain in several surgical procedures, including breast, thoracic, spine and hip surgery. Due to its recognizable anatomy and low complication rate, the application of ESPB has been significantly increased. However, it is rarely used in clinical practice for postoperative analgesia after posterior lumbar spine surgery, while the choice of adjuvant drugs, block levels and drug doses remain controversial. Based on the current literature review, ropivacaine and dexmedetomidine could be considered as the best available drug combination. The present review aimed to analyze the currently available clinical evidence and summarize the benefits and challenges of ESPB in spinal surgery, thus providing novel insights into the application of ESPB in the postoperative management of posterior lumbar surgery.

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Section: Ultrasound-guided Espbmentioning

confidence: 99%

“…Ultrasound-guided ESPB often requires additional preparation space, time and sedation (62). Accurate ultrasound localization in obese patients and severely degenerated spinal structures remains a challenge (20). However, obesity and severe spinal degeneration are common in lumbar fusion surgery.…”

Section: Limitations and Drawbacksmentioning

confidence: 99%

Ultrasound‑guided erector spinae plane block in posterior lumbar surgery (Review)

Deng,

Huang,

2024

Biomed Rep

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Erector Spinae Plane Block Placement Utilizing Fluoroscopic Guidance Improves Efficiency in Lumbar Surgery

Patel,

Dincer,

Wiepert

et al. 2024

World Neurosurgery

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Efficacy of erector spine plane block in two different approaches to lumbar spinal fusion surgery: a retrospective pilot study

Birnbaums,

Ozoliņa,

Solovjovs

et al. 2024

Front. Med.

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BackgroundErector spine plane block (ESPB) has been widely used in spinal surgery, although there are variable data about its efficacy.ObjectivesThis study aimed to evaluate the efficacy of ESPB in elective lumbar spinal fusion surgery patients with two different surgical approaches.Materials and methodsRetrospectively, 45 elective lumbar transpedicular fusion (TPF) surgery patients undergoing open surgery with different approaches [posterior transforaminal fusion approach (TLIF) or combined posterior and anterior approach (TLIF+ALIF)] were divided into 2 groups: general anesthesia (GA, n = 24) and general anesthesia combined with ESPB (GA + ESPB, n = 21). The primary outcome was to analyze the efficacy of ESPB in two different surgical approaches in terms of pain intensity in the first 48 h. Secondary: Fentanyl-free patients and opioid consumption in the first 24 h postoperatively. Comparative analysis was performed (SPSS® v. 28.0) (p < 0.05).ResultsOut of 45 patients (27 female), 21 received GA + ESPB and 24 received GA. The average age was 60.3 ± 14.3 years. Chronic back pain before the operation was registered in 56% of patients. ESPB was performed in 17 TLIF and in 4 TLIF+ALIF patients. ESPB significantly reduced pain intensity at rest in both surgical approaches 48 h after surgery (p < 0.05). The need for postoperative fentanyl infusion was significantly lower in the group treated with GA + ESPB in both surgical approaches than in those who only received GA (29% vs. 77% in TLIF and 0% vs. 80% in TLIF+ALIF); p = 0.01 and p = 0.004. Additionally, we observed that ESPB provides a good analgesic effect for up to 6.8 ± 3.2 h in the TLIF and 8.9 ± 7.6 h in the TLIF+ALIF approaches. Consequently, ESPB reduced the initiation of the fentanyl compared to GA alone, with a mean difference of 3.2 ± 4.2 h in the TLIF subgroup (p = 0.045) and 6.7 ± 5.3 h in TLIF +ALIF (p = 0.028). Only in the TLIF+ALIF approach, ESPB reduced the total fentanyl consumption compared to those with GA (1.43 ± 0.45 mg/24 h vs. 0.93 ± 0.68 mg/24 h; p = 0.015).ConclusionESPB significantly reduced pain at rest after surgery, the number of patients requiring immediate postoperative fentanyl analgesia, and total fentanyl consumption in both surgical approaches, particularly in TLIF+ALIF. However, the application of ESPB does not always provide completely sufficient analgesia.

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Fluoroscopic-guided erector spinae plane block for spine surgery

Cited by 3 publications

References 9 publications

Ultrasound‑guided erector spinae plane block in posterior lumbar surgery (Review)

Ultrasound‑guided erector spinae plane block in posterior lumbar surgery (Review)

Erector Spinae Plane Block Placement Utilizing Fluoroscopic Guidance Improves Efficiency in Lumbar Surgery

Efficacy of erector spine plane block in two different approaches to lumbar spinal fusion surgery: a retrospective pilot study

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