Efficacy of erector spinae plane block for transforaminal endoscopic surgery / 中华麻醉学杂志

ABSTRACT

Objective:To evaluate the efficacy of erector spinae plane block (ESPB) for transforaminal endoscopic surgery.Methods:Sixty patients of both sexed, aged 20-45 yr, with body mass index of 17.5-29.0 kg/m 2, of American Society of Anesthesiologists physical status ⅠorⅡ, undergoing percutaneous transforaminal endoscopic lumbar discectomy, were divided into 2 groups ( n=30 each) by using a random number table method: ESPB group (E group) and local infiltration anesthesia group (L group). Group E received the ultrasound-guided ESPB, group L received layer-by-layer-assisted local infiltration anesthesia (including subcutaneous layer and fascia, muscular layer and superior articular process) according to the location of operation, and 0.5% ropivacaine 20 ml was used as local anesthetic in both groups.Operation time and C-arm X-ray localization time were recorded.Visual analogue scale score and Ramsay sedation score were recorded at skin incision (T 1), muscle separation (T 2), foraminoplasty (T 3), nerve root decompression (T 4) and skin suture (T 5). The effective analgesia and satisfaction with sedation were recorded.Patients were followed up postoperatively for patient satisfaction, lower extremity motor block, development of nausea and vomiting, dizziness, hematoma at puncture site, nerve damage and etc.Functional status was assessed using the Oswestry Disability Index. Results:Compared with group L, visual analogue scale scores were significantly decreased at T 2-4, Ramsay sedation scores were increased at T 3, 4, patient′s satisfaction was increased, operation time and C-arm X-ray localization time were shortened ( P<0.05), and no significant change was found in Oswestry Disability Index score or rate of satisfactory analgesia in group E ( P>0.05). No motor block, nausea and vomiting, dizziness, hematoma at puncture site and nerve damage was found in both groups. Conclusion:ESPB can provide satisfactory analgesia with a higher safety when used for trasforaminal endoscopic surgery.