Opioid Use Down With Erector Spinae Plane Blocks in Lumbar Laminectomy

Bilateral erector spinae plane blocks combined with multimodal analgesia also reduces pain scores, need for antiemetic therapy

THURSDAY, Nov. 9, 2023 (HealthDay News) — For patients undergoing open lumbar laminectomy, ultrasound-guided bilateral erector spinae plane blocks (ESPBs) combined with multimodal analgesia reduce opioid consumption, according to a study recently published in the European Spine Journal.

Jesse W. Stewart, M.D., from UT Southwestern Medical Center in Dallas, and colleagues compared the analgesic effects of preoperative, bilateral, ultrasound-guided ESPBs combined with standardized multimodal analgesia with multimodal analgesia alone (25 patients in each group) among patients undergoing one or two level open lumbar laminectomy.

The researchers found that with ESPBs, opioid requirements at 24 hours were significantly lower (31.9 ± 12.3 versus 61.2 ± 29.9 mg oral opioid equivalents). In the postanesthesia care unit (PACU) and through postoperative day two, pain scores were significantly lower with ESPBs. Fewer patients in the ESPB group versus the non-ESPB group received postoperative antiemetic therapy (12 versus 48 percent). In addition, significantly shorter PACU duration was seen with ESPBs (49.7 ± 9.5 versus 79.9 ± 24.6 minutes).

“These findings suggest that ESPBs can play a major role in an opioid-sparing recovery plan that utilizes a multimodal pain management approach, not only in spine surgery but potentially for other types of surgery as well,” Stewart said in a statement.

One author disclosed ties to Baxter Pharmaceuticals.

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