The Effect of bılateral Erector spına Plan Block on postoperatıve paın ın spınal Surgery

The Effect of Bilateral Erector Spina Plan Block Performed After Lumbar Spinal Stabilization Surgery on Postoperative Patient Recovery and Pain

Patients undergoing lumbar spinal stabilization surgery may experience severe postoperative pain lasting at least three days. Analgesia after lumbar stabilization surgery is beneficial for early recovery and is therefore necessary. However, traditional opioid-based analgesic techniques are associated with many undesirable effects, including nausea, vomiting, itching, and sedation. Inadequate postoperative pain control also has numerous adverse effects on physiological systems such as the cardiovascular, pulmonary, gastrointestinal, immunological, renal, and hematological systems. Furthermore, inadequate postoperative pain control increases hospital stay, mortality and morbidity, prolongs patient ambulation time, increases patient costs, reduces patient satisfaction, and can lead to chronic postoperative pain. Nonsteroidal anti-inflammatory drugs (NSAIDs), opioid analgesics, and local anesthetics are frequently preferred options for providing postoperative analgesia. In cases where these agents are insufficient to prevent pain, regional techniques are often preferred to reduce the need for opioids. Erector spina plane block (ESPB), a component of multimodal analgesia and one of the regional techniques, was first used by Forero et al. for analgesic purposes in thoracic neuropathic pain and subsequently gained popularity. While ESPB is frequently performed at the thoracic level, its use continues to increase today.

Ultrasound-guided erector spinae plane block (ESPB) that aims for the ventral and dorsal rami of the spinal nerves was recently introduced in spine surgery to treat postoperative pain. ESPB was reported to be effective in scoliosis surgery as it reduced the need for analgesic drugs. Due to its relative technical simplicity, the main advantages postulated for the ESPB are few complications and minimal risk for spinal cord injury.

Inclusion Criteria:•

• • Patients who volunteer to participate in the study

  • Patients aged 18-65 years
  • Patients with ASA (American Society of Anesthesiologists) physical status I, II, and III
  • Patients who will undergo elective lumbar stabilization surgery

Exclusion Criteria:

• • Patients who do not consent to participate in the study

  • Patients with ASA physical status IV and V
  • Patients using anticoagulant medications
  • Patients with allergy to local anesthetic drugs
  • Patients undergoing lumbar stabilization surgery at level three or higher
  • Patients with a history of gastrointestinal bleeding
  • Patients with a history of psychiatric illness (Major Depression, Schizophrenia, Bipolar Affective Disorder)
  • Patients with narcotic drug and/or alcohol dependence
  • Patients with a history of central and/or peripheral neurological disease