Erector spinae plan block (ESPB) with Ropivacaine and standard postoperative pain protocol

No erector spinae plane block (ESPB) or type of injection and standard posteropative pain protocol

This drug is approved as a local anesthetic.

Institutional pain management protocol: patients have a hydromorphone patient-controlled analgesia pump until post-operative day 1 and as needed (PO) methadone two times a day, as well as PO oxycodone every 4 hours as needed for moderate pain and IV hydromorphone every 2 hours as needed for severe pain. PO diazepam is available every 6 hours for muscle spasms. The oral morphine equivalents and benzodiazepine doses used in the first 72 hours after surgery will be the primary method of assessing postoperative pain and muscle spasms respectively.

Pain will be measured on a numerical scale from zero to ten, with zero being no pain at all and ten being the worst pain you have ever felt. Scores will be gathered at multiple time points the day of surgery, and post-op day 1, 2 and 3. We will take the average pain score. These numerical pain scores will be the secondary method of assessing postoperative pain.

Time to clearance from physical therapy (PT) is a measure that demonstrates the amount of time required to obtain a functional level of mobilization after surgery. This mobilization is often pain limited. For neuromuscular patients with mobility limitations, aim 3 will be measured based on when patients are cleared by PT for safe discharge home. We will measure time to clearance in both groups.