|Identified the Clinical Benefits and Effective Levels of Block Approach for Erector Spinae Plane Blo|
|Date||Modified Date : 2022.06.16|
Research Team Led by Professor Byung Gun Lim at the Department of Anesthesiology and Pain Medicine Identified the Clinical Benefits and Effective Levels of Block Approach for Erector Spinae Plane Block (ESPB)
Clinical analgesic efficacy of ESPB was proven by a systematic review with meta-analysis of previously reported randomized controlled trials
‘Analgesic efficacy of erector spinae plane block in lumbar spine surgery: A systematic review and meta-analysis,’ written by a research team led by Professor Byung Gun Lim of Korea University Guro Hospital (including the first author, Assistant professor Seok Kyeong Oh) was published in the June issue of the Journal of Clinical Anesthesia (ISSN: 0952-8180, U.S.), an international journal of Anesthesiology and Perioperative Medicine.
Erector spinae plane block (ESPB) introduced in 2016 is a nerve block technique in which local anesthetic is injected into the fascial plane between the transverse process of the vertebra and the erector spinae muscles. It has been proven to be effective for various surgical procedures, including breast, thoracic and abdominal surgery. However, there has been little evidence to show its analgesic efficacy in lumbar spine surgery. This study was designed to demonstrate the efficacy of ESPB in lumbar spine surgery through a systematic review and meta-analysis of previously reported articles of randomized controlled trials.
The study was conducted on the patients who underwent lumbar spine surgery under general anesthesia. The group of patients who received ESPB was compared with a control group of patients who did not undergo the block technique or who were injected with a sham block (saline injection) instead of local anesthetic. The team compared the two groups based on the opioid consumption for 24 hours after surgery, postoperative pain score for 48 hours, incidence of postoperative nausea and vomiting, patient satisfaction and length of hospital stay.
Twelve randomized controlled trials comprising 665 participants were included and analyzed. Compared to the control, ESPB significantly reduced the opioid consumption for 24 hours after surgery, and lowered the pain scores at various time points (at rest or during movement) for 48 hours after surgery. Also, the ESPB group showed lower incidence of postoperative nausea and vomiting, a higher level of patient satisfaction, and shorter length of hospital stay. Furthermore, a subgroup analysis revealed an additional reduction in opioid consumption by the block approach at the vertebral level of incision or operation than that at the fixed thoracic or lumbar level.
This study demonstrated the clinical benefits of ESPB for the patients undergoing lumbar spine surgery. In particular, it found that performing such block technique at the corresponding vertebral level of incision or operation rather than fixed spine level was more effective in relieving postoperative pain.
“In patients undergoing lumbar spine surgery under general anesthesia at the clinical scene, performing ESPB on the vertebral level of incision or operation can be more effective to manage their postoperative pain,” said Professor Byung Gun Lim at the Department of Anesthesiology and Pain Medicine of Korea University Guro Hospital. He added: “By reducing the opioid consumption and its consequent complication risks, the block technique will also contribute positively to a higher level of patient satisfaction and improving the hospital bed occupancy rate.”
In the meantime, the Journal of Clinical Anesthesia, in which the results of this study were published, has the highest Journal Impact Factor (9.452) of medical journals in the Anesthesiology category (2020 Journal Impact Factor, Journal Citation Reports, Clarivate).