ESP Block Versus Wound Infiltration for Laminectomy

  • STATUS
    Recruiting
  • End date
    May 20, 2023
  • participants needed
    112
  • sponsor
    University of Padova
Updated on 14 June 2022

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

Details
Condition Pain, Postoperative, Opioid Use, Anesthesia, Local, Surgery
Treatment ESP block with saline, Wound infiltration with saline, ESP block with local anesthetic, Wound infiltration with local anesthetic
Clinical Study IdentifierNCT05271331
SponsorUniversity of Padova
Last Modified on14 June 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Planned 1 or 2 level surgical laminectomy

Exclusion Criteria

Allergy to local anesthetics
Refusal of consent
Uncompensated cardiopathies, nephropathies, liver disease or peripheral neuropathies
Hemopathies that predispose to bleeding
Gastrointestinal ulcer or bleeding
Local infection
Psychiatric or neurological disorders (except those attributed to primary disease for which intervention is planned) History of abuse (or use in the 24 hours prior to surgery) Alcohol addiction ASA > 3
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