Comparative Evaluation of Ultrasound Guided Bilateral Erector Spinae Block and Ultrasound Guided Caudal Block in Lumbar Spine Surgeries for Post Operative Analgesia

Abstract

Background: Effective management of pain following spine surgeries is essential to enhance functional outcomes, facilitate early ambulation, expedite recovery, and avert the onset of chronic pain. Epidural analgesia is regarded by many as a fundamental component of postoperative analgesia for lumbar spine surgeries. A unique interfacial plane block that has lately gained popularity is the erector spinae plane block. Aim and Objectives: The goal of this research was to evaluate the analgesic effect of ultrasound guide bilateral erector spinae block and ultrasound guided caudal block in lumbar spine surgeries for post-operative analgesia. Material and Methods: Following the approval of institutional ethical committee, this randomized controlled study was done on 40 patients presenting for lumbar spine surgery in Sri Siddhartha Medical College and Research Institute, Tumkur, Karnataka, India. Patients were randomly assigned equally to receive either ultrasound guided caudal block (Group C) or receive bilateral ultrasound guided lumbar ESP block (Group E) after induction of general anaesthesia. Time to first analgesia request postoperatively was recorded. VAS score and VCS score was used to assess quality of postoperative analgesia. An analysis of the data was conducted using SPSS version 20. Statistical analysis was conducted on continuous and categorical data using the suitable statistical approach. A significance level of P < 0.05 was used to determine statistical significance. Result: The mean time to 1st analgesia request in group E (ultrasound guided bilateral Erector spinae block) was found to be 7:28±1.00 hrs while the mean time to 1 st analgesia request in group C (ultrasound guided caudal block) was found to be 4:04±1.00 hrs (P<0.001). Conclusion: Ultrasound-guided bilateral erector spinae block (ESPB) has been shown to be effective for lumbar spine surgeries by extending the duration of postoperative pain relief and reducing the need for first rescue analgesia compared to patients who received an ultrasound-guided caudal block without any complications. The block's simplicity and safety contribute to its growing popularity.