ESP Block Versus Wound Infiltration for Laminectomy
Status:
Not yet recruiting
Trial end date:
2023-03-22
Target enrollment:
Participant gender:
Summary
Spinal surgery is often burdened by perioperative pain and its treatment presently represents
a challenge for anesthetists. An inadequate intra and postoperative analgesic therapy leads
to a delay in the mobilization of the patients, prolonged hospital stay and thromboembolic
complications, as well as the onset of chronic pain syndromes . Effective pain treatment can
help improve surgical outcome for patients undergoing spinal surgery. From the
pathophysiological point of view pain in vertebral surgery can originate from different
anatomical structures: vertebrae, discs, ligaments, dura mater, facet joints, muscles and
skin-subcutis. The terminal innervation of these tissues originate from the dorsal branches
of the spinal nerves, and this represents a target a multimodal approach to perioperative
analgesia in vertebral surgery. Systemically administered drugs such as NSAIDs, opioids,
ketamine, intravenous lidocaine could benefit from the addition of locoregional therapies
such as neuraxial blocks (anesthesia peridural or subarachnoid) or as shown more recently by
other anesthesia techniques locoregional ultrasound-guided In recent years the
anesthesiological interest has focused on the Erector Spinae Plane Block (ESPB). First
described by Forero et al, it is a paraspinal interfascial block targeting the dorsal and
ventral branches of the spinal nerves just after their emergence from the spinal cord. In the
ultrasound-guided technique the local anesthetic is injected between the deep fascia of the
muscle itself and the transverse processes of the vertebrae at the level interested. The aim
of this study is to evaluate the efficacy of ESPB when compared to wound infiltration in
patients undergoing laminectomy