Study Design: 

Retrospective.

Objective: 

The purpose of this study was to determine the utility of the erector spinae plane regional anesthesia (ESP) block in reducing opioid medication usage and postanesthesia care unit length of stay (PACU-LOS) for patients undergoing either a posterior or transforaminal lumbar interbody fusions (PLIF/TLIF).

Summary of Background Data: 

Posterior lumbar spine fusion is a common surgical procedure typically associated with significant postoperative pain. Poorly controlled postoperative pain can lead to a number of poor outcomes. Although opioids are a mainstay for pain control, they are associated with adverse effects and a risk of dependence. Therefore, multimodal pain control has become more prevalent in orthopedics and combines traditional opioid and nonopioid pain mediation with general anesthesia protocols and regional nerve blocks.

Materials and Methods: 

A retrospective chart review was conducted for patients undergoing PLIFs or TLIFs between 2019 and 2021. Patients were placed into 2 groups, those receiving an ESP block and those that did not. T tests assuming unequal variances were used to assess differences in pain scores, opioid consumption, and PACU-LOS between groups.

Results: 

The study group demonstrated a 35% reduction in opioid use (P=0.016), a 16% reduction in pain with activity (P=0.042), and a 9.7% reduction in pain at rest (P=0.219) compared with the control group. There were no significant differences in PACU-LOS between groups (P=0.314).

Conclusion: 

The use of an ESP block for patients undergoing PLIFs and TLIFs appears to be a safe and effective means to manage postoperative pain and reduce opioid consumption.

中文翻译：

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竖脊肌平面阻滞在腰椎融合术后疼痛管理和阿片类药物减少中的应用

学习规划： 

回顾性的。

客观的： 

本研究的目的是确定竖脊肌平面区域麻醉(ESP) 阻滞在减少接受后路或经椎间孔腰椎椎间融合术患者的阿片类药物使用和麻醉后监护室住院时间 (PACU-LOS) 方面的效用。 PLIF/TLIF）。

背景数据摘要： 

后路腰椎融合是一种常见的外科手术，通常会带来严重的术后疼痛。术后疼痛控制不佳可能会导致许多不良结果。尽管阿片类药物是控制疼痛的主要手段，但它们会带来不良反应和依赖风险。因此，多模式疼痛控制在骨科中变得更加普遍，并将传统的阿片类和非阿片类疼痛调解与全身麻醉方案和区域神经阻滞相结合。

材料和方法： 

对 2019 年至 2021 年间接受 PLIF 或 TLIF 的患者进行了回顾性图表审查。患者被分为 2 组：接受 ESP 阻滞的组和未接受 ESP 阻滞的组。假设方差不等的 T 检验用于评估组间疼痛评分、阿片类药物消耗和 PACU-LOS 的差异。

结果： 

与对照组相比，研究组的阿片类药物使用量减少了 35%（P =0.016），活动时疼痛减少了 16%（P =0.042），静息时疼痛减少了 9.7%（P =0.219） 。各组间PACU-LOS无显着性差异（P =0.314）。

结论： 

对接受 PLIF 和 TLIF 的患者使用 ESP 阻滞似乎是控制术后疼痛和减少阿片类药物消耗的安全有效的方法。