Erector Spinae Plane Block vs Transforaminal Epidural Injection

Ataturk University

Status: Unknown

Conditions: Discogenic Low Back Pain

Treatments: Device: Fluoroscopy; Drug: Bupivacaine;Dexamethasone Solution for Injection; Device: Ultrasound

Study type: Interventional

Funder types: Other

Identifiers

NCT04212845

ESPB vs TF

Details and patient eligibility

About

Lumbar disc herniation is the main cause of low back pain and radicular leg pain. Steroids administered to the epidural area reduce the inflammatory response and pain by inhibiting the synthesis of proinflammatory agents. Epidural steroid injections are used in the treatment of lumbosacral radicular pain with various techniques including fluoroscopy-guided transforaminal and interlaminar injection.

Ultrasound-guided erector spina plan block (ESPB) was first described in 2016 and has been used for postoperative analgesia in many surgeries including thoracic and lumbar dermatomes. The distribution of local anesthesia in the ESPB from the paravertebral area to the transforaminal and epidural space has been shown in studies.

The aim of this study was to compare the efficacy of ultrasound-guided ESPB and fluoroscopic guided transforaminal epidural steroid injection in chronic discogenic low back pain.

Enrollment: 60 estimated patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiologist's physiologic state I-III patients
• Patients with unilateral radicular pain and low back pain persisting despite medical treatment.

Exclusion criteria

• Spinal cord disease or spinal mechanical instability,
• Previous low back surgery,
• More than two levels of lumbar disc hernia,
• Allergic to local anesthetic drugs to be used,
• Use of oral anticoagulants,
• Uncontrolled diabetes mellitus type I and II

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 2 patient groups

Group ESP

Active Comparator group

Description:

Ultrasound-Guided erector spinae plane block with 30 ml of 0.25% bupivacaine and 8 mg dexamethasone

Treatment:

Device: Ultrasound

Drug: Bupivacaine;Dexamethasone Solution for Injection

Group TF

Active Comparator group

Description:

Fluoroscopy-guided transforaminal injection with 4 ml of 0.25% bupivacaine and 8 mg dexamethasone

Treatment:

Device: Fluoroscopy

Drug: Bupivacaine;Dexamethasone Solution for Injection