The Effect of High-thoracic Erector Spinae Plane Block on Postoperative Pain and Diaphragmatic Function in Posterior Cervical Spine Surgery

Benha University

Status and phase: Completed; Phase 3

Conditions: Cervical Spine Surgery; Pain Management

Treatments: Procedure: Erector spina plane block (ESP); Drug: Bupivacain (preoperative)

Study type: Interventional

Funder types: Other

Identifiers

NCT06721832

RC 13-10-2024

Details and patient eligibility

About

Posterior cervical spine surgery, often performed on older individuals with significant comorbidities, is one of the most painful surgical operations. Anesthesiologists face a unique challenge in managing pain following these surgeries,Erector spinae plane block (ESPB) is a relatively novel block and was first described for chronic thoracic neuropathic pain in 2016.Cervical erector spinae plane (ESP) block has been described to anesthetize the brachial plexus (BP), however, the mechanism of its clinical effect remains unknown. As the prevertebral fascia encloses the phrenic nerves, BP and erector spinae muscles to form a prevertebral compartment, a local anesthetic injected in the cervical ESP could potentially spread throughout the prevertebral compartment

Enrollment: 50 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• (ASA )classes I and II
• patients of either sex
• above the age of 18 who will undergo posterior cervical surgery

Exclusion criteria

• patient's refusal to participate
• any contraindications to peripheral nerve blocks
• history of ischemic heart disease
• patients on opioids for chronic pain
• patients with significant cognitive impairment

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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50 participants in 2 patient groups, including a placebo group

Group E

Active Comparator group

Description:

patients will receive bilateral in-plane ultrasound guided erector spinea plane block with 30 ml of bupivacaine 0. 25% (15 ml in each side) after induction of general anesthesia

Treatment:

Drug: Bupivacain (preoperative)

Procedure: Erector spina plane block (ESP)

Group C

Placebo Comparator group

Description:

patients will receive a sham block with saline at the corresponding puncture site and same volumes as in group E (sham block) after induction of general anesthesia

Treatment:

Procedure: Erector spina plane block (ESP)