A Novel Combined Anesthetic Technique to Improve the Surgical Working Conditions of Lumbar and Thoracolumbar Spine Surgery from a Spine Surgeon’s Perspective: A Prospective Randomized Controlled Study

ABSTRACT

Methods@#A prospective randomized study of 76 patients who underwent lumbar and thoracolumbar surgeries was conducted by randomly allocating patients into three anesthetic groups GA alone, GA with spinal anesthesia (SA), and GA with erector spinae plane block (ESPB) by the allocation concealment method to avoid selection bias. The working conditions were assessed by the same operating surgeon who was blinded by the type of anesthesia to eliminate the assessment bias. Muscle relaxation and surgical field were compared among the three groups along with other hemodynamic parameters to identify any significant differences. @*Results@#Significantly better muscle relaxation, surgeon satisfaction, postoperative analgesia, and blood pressure (BP) were observed in the GA+RA when compared to GA alone (p 0.05). Complications were only observed in the GA+SA group (19%). @*Conclusions@#The study results suggest that the addition of RA to GA may provide better working conditions and surgeon’s satisfaction by improving relaxation of the erector spinae in addition to decreasing the BP and postoperative pain in contrast to the use of GA alone. The combined GA and ESPB techniques may be a viable anesthetic alternative to provide better working conditions for surgeons.