External oblique vs. thoracoabdominal nerve block for analgesia in sleeve gastrectomy: RCT

Erector spinae plane block (ESPB) can be used for analgesia after lumbar spine surgery. However, its effect on postoperative quality of recovery (QoR) remains underexplored in patients undergoing transforaminal lumbar interbody fusion (TLIF) or oblique lumbar interbody fusion (OLIF). This study hypothesized that ESPB would improve the postoperative QoR in such patients.

Patients scheduled to undergo TLIF or OLIF were randomized into ESPB (n = 38) and control groups (n = 38). For the ESPB group, 25 mL of 0.375% bupivacaine was injected into each erector spinae plane at the T12 level under ultrasound guidance before skin incision. Multimodal analgesia, including wound infiltration, was uniformly applied to both groups. To assess perioperative QoR, the QoR-15 score was measured before surgery and 1 (primary outcome measure) and 3 days after surgery. Postoperative pain at rest and during ambulation and postoperative ambulation were also evaluated for 3 days after surgery.

Perioperative QoR-15 scores were not significantly different between the ESPB and control groups including that 1 day after surgery (80 ± 28 vs. 81 ± 25). Although other postoperative pain scores did not significantly differ between the groups, the ESPB group had a significantly lower pain score during ambulation 1 h after surgery (7 ± 3 vs. 9 ± 1) and significantly shorter time to the first ambulation after surgery (2.0 [1.0–5.5] h vs.5.0 [1.8–10.0] h).

ESPB did not provide additional benefits for the postoperative QoR in patients who underwent TLIF or OLIF with multimodal analgesia.