Is Opioid-free Anesthesia Possible by Using Erector Spinae Plane Block in Spinal Surgery?

Objective: Erector spinae plane (ESP) block can be a method to be used for postoperative pain control in lumbar herniated disc operations. The aim of this study is to investigate the effect of erector spinae block in lumbar herniated disc operation on intraoperative and postoperative opioid consumption. Methods: Sixty patients scheduled for lumbar herniated disc surgery were included in the study. Patients were randomized into two groups: ESP block and control. Ultrasound-guided ESP block with 20 ml 0.25% bupivacaine at the bilateral L3 vertebral level was applied preoperatively to all patients in the ESP group. Patients in both groups were provided with intravenous patient-controlled analgesia (PCA) device containing fentanyl for postoperative analgesia. Fentanyl consumption and visual analogue scale (VAS) score were recorded at 15 min, 1, 6, 12, and 24 hours postoperatively. Results: Fentanyl consumption (group C: 59.3 ± 20.66, group E: 41.3 ± 21.61, p: 0,02) and VAS score (group C: VASm 4 (2-4), group E: 2 (2-4), p: 0.009) decreased with ESP block application at postoperative one hour. No difference was detected between the two groups in terms of fentanyl consumption and VAS score at 6, 12, and 24 hours postoperatively (p>0.05). The intraoperative heart rate of patients in the ESP group was lower than the control group (p<0.05). Conclusion: ESP block decreases opioid consumption and VAS score at postoperative one hour in patients, and also patients who receive ESP block do not require intraoperative opioid administration.