ESP Block in MIS Lumbar Spine Surgery

Hospital for Special Surgery (HSS)

Status: Enrolling

Conditions: Patients With Spinal Stenosis Indicated for MIS TLIF

Treatments: Procedure: Erector spinae plane (ESP) block

Study type: Interventional

Funder types: Other

Identifiers

NCT05856539

2021-1386

Details and patient eligibility

About

This is a prospective, randomized controlled trial of patients undergoing minimally invasive transforaminal lumbar interbody fusion. This study will randomize patients into one of two groups: erector spinae plane (ESP) block and no ESP block.

Full description

Minimally invasive (MIS) spinal surgical procedures such as MIS transforaminal lumbar interbody fusion (TLIF) are being increasingly performed due to reduced morbidity. However, the mainstay for perioperative analgesia after these surgeries remains to be opioid pain medications, which have a number of associated adverse effects such as respiratory depression, hyperalgesia, and opioid habituation. Recently, the erector spinae plane (ESP) block has been introduced as an opioid-sparing regional anesthetic for lumbar spinal surgery with touted benefits including opioid use reduction and improved pain control. The proposed study aims to enroll patients in a double blind randomized controlled trial to undergo MIS TLIF with an ESP block or as conventional control group. Preoperative patient demographics, comorbidities, history of opioid use, and operative details will be obtained. Comprehensive assessment of opioid utilization, postoperative pain, non-opioid pain medication use, opioid-induced complications, time to opioid cessation, time to physical therapy clearance, length of stay, as well as other related outcomes will be performed.

Enrollment: 48 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 18-80
• Patients scheduled for MIS TLIF (any level) with the principal investigator
• ASA 1, 2, 3

Exclusion criteria

• ASA 4 or higher
• BMI >40
• Chronic opioid use (daily use for > 3 months)
• Revision surgery, any history of previous lumbar spine surgery
• Allergy to any of the study medications
• Non-English speaking
• Chronic renal insufficiency or failure (creatinine >2) or severe hepatic disease (cirrhosis, failure)
• Pregnancy
• Any concomitant surgery

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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48 participants in 2 patient groups

ESP Block

Experimental group

Description:

Patients assigned to the "ESP Block" arm will receive an ESP block prior to the surgery.

Treatment:

Procedure: Erector spinae plane (ESP) block

Control

No Intervention group

Description:

Patients assigned to the "Control" group will not receive an ESP block prior to the surgery.