Comparative Study between Erector Spinae Plane Block versus Intravenous Morphine as Postoperative Analgesia after Spine Surgeries

Abstract

Background: Postoperative pain is defined as acute pain present at the surgical site or related to it after procedure.

Objective: This work was aimed at performing a comparison between the erector spinae plane block (ESPB) impact in comparison with  Intravenous morphine for postoperative analgesia following spine surgeries.

Patients and Methods: This prospective randomized  double-blind research included sixty individuals with ASA physical status class I and class II going through an uncomplicated spine  surgery with general anesthesia. All participants went through a categorization into two equal groups; 30 in each. The first group patients  were administered bilateral ultrasound guided ESPB utilizing plain bupivacaine at a dosage of 100 mg diluted to volume with  saline, thus obtaining 50% concentration (50 mg plain bupivacaine in each side), The second group: received a dosage of 0.1 mg /kg of IV morphine diluted with saline to 10 ml volume when the surgical procedure is completed.

Results: Postoperative heart rate (HR), mean  arterial pressure (MAP), respiratory rate (RR), and visual analogue measurements (VAS) were significantly lower at 6h,12h and 24h within  the first group as opposed to the second one (P value<0.05). Duration till the first analgesic need was significantly longer within group 1.  Total paracetamol dosages within initial twenty-four hours postoperatively were significantly lower in group 1. PONV, hypotension and bradycardia were insignificantly varied among both groups.

Conclusions: Using ESPB in spine surgeries is associated with better  analgesic outcomes through pain score, duration till the first analgesia need and total paracetamol administration with no difference  regarding complications compared to intravenous morphine.