A Prospective Randomised Controlled Trial Comparing Efficacy Of Free Hand Landmark Guided Versus Ultrasound Guided Bilateral Erector Spinae Plane Block In Lumbar 2-3 Level Spine Surgeries.
DOI:
https://doi.org/10.53555/AJBR.v28i1.6569Keywords:
Erector spinae block., Visual Analogue Scale, Lumbar spine surgeriesAbstract
BACKGROUND & AIMS:
Spine surgeries are often associated with significant postoperative pain, typically lasting up to three days. The role of Ultrasonography (USG) guided, and landmark guided erector spinae plane block (ESPB) has been established as part of a multimodal analgesic approach. However, there are no Randomised Controlled Trials conducted to compare the two techniques, which formed the basis of this trial.
METHODS:
Following ethics committee clearance and registration at Clinical trials registry-India, CTRI/2024/03/064379. 130 patients who were undergoing 2-3 level lumbar spine surgeries and fulfilled the criteria were randomly allocated to Group A (65) who received an anatomical landmark method administered ESPB by a spine surgeon and Group B (65) who received an USG guided ESPB by an anaesthesiologist. Visual Analogue Scale (VAS) pain scores, opioid consumption, hemodynamic stability, incidence of postoperative nausea and vomiting (PONV), mobilization time, hospital stay duration, and patient satisfaction were assessed.
RESULTS:
VAS pain scores were consistently lower in the USG group than in the landmark group within the first 16 hours, although the differences were not statistically significant at 8 and 16 hours. Opioid consumption and hemodynamic responses were comparable between groups. PONV, mobilization time, hospital stay, and satisfaction scores also showed no significant differences.
CONCLUSION:
Both techniques provide similar analgesic outcomes, with the landmark technique offering a viable, cost-effective alternative in settings where USG equipment or expertise is unavailable.
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Copyright (c) 2024 Dr Anjana Kashyap, Dr Madhava Pai K (Author)

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