Erector Spinae Plane Blockade in Pediatric Scoliosis Surgery Patients

  • STATUS
    Recruiting
  • days left to enroll
    17
  • participants needed
    50
  • sponsor
    Stanford University
Updated on 3 September 2021
analgesia
local anesthetic
inflammatory response
scoliosis surgery
spinal fusion
spinal instrumentation

Summary

Providing effective analgesia after spinal fusion for idiopathic scoliosis remains a challenge with significant practice variation existing among high volume spine surgery centers. Even in the era of multimodal analgesia, opioids are the primary analgesics used for pain control after pediatric scoliosis surgery, but have multiple known adverse effects. The erector spinae plane block (ESPB) is a newly described fascial plane block performed by injecting local anesthetic between the erector spinae muscle and the transverse process. Additionally, there are case reports describing the ESPB as part of a multi-modal analgesic plan in adult degenerative spine surgery as well as adult spinal deformity surgery, demonstrating effective analgesia and no clinical motor blockade. Although it is known that the inflammatory reaction plays a crucial role in the mechanism of acute pain after major surgery, the effectiveness of the current regional approach on inflammatory response is not well studied.

Details
Condition Scoliosis; Juvenile, Scoliosis; Adolescence
Treatment Erector Spinae Plane blockade
Clinical Study IdentifierNCT04153994
SponsorStanford University
Last Modified on3 September 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

ASA I-III
Diagnosed with Idiopathic scoliosis
Undergoing single-stage posterior spinal instrumentation and fusion

Exclusion Criteria

Thorascopic tethering procedure
Two-stage procedure
Abnormal developmental profile
Congenital/neuromuscular scoliosis
Requiring PICU admission
Known allergy to lidocaine
Known cardiac, renal or liver disease or dysfunction
Pre-existing pain complaints, i.e. on regular analgesic medications
Current psychiatric diagnosis, e.g. anxiety, depression, eating disorder, defined according to DSM criteria
Requiring non-standard post-op pain management
Any history of seizures
Unplanned staged procedure
Weight < 5th centile or > 85th centile for age
Porphyria
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