Effectiveness of ESP-block and epidural analgesia in spinal surgery: a prospective randomized study

Morunova A.Yu.

Privolzhsky Research Medical University

ORCID: 0000-0003-4624-840X

Ezhevskaya A.A.

Privolzhsky Research Medical University

ORCID: 0000-0002-9286-4679

Prusakova Zh.B.

Privolzhsky Research Medical University

ORCID: 0009-0009-5481-5399

Zagrekov V.I.

Privolzhsky Research Medical University

ORCID: 0000-0001-8235-7705

Effectiveness of ESP-block and epidural analgesia in spinal surgery: a prospective randomized study

Authors:

Morunova A.Yu., Ezhevskaya A.A., Prusakova Zh.B., Zagrekov V.I.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2024;(5): 72‑81

DOI: 10.17116/anaesthesiology202405172

Downloaded: 5

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To cite this article:

Morunova AYu, Ezhevskaya AA, Prusakova ZhB, Zagrekov VI. Effectiveness of ESP-block and epidural analgesia in spinal surgery: a prospective randomized study. Russian Journal of Anesthesiology and Reanimatology. 2024;(5):72‑81. (In Russ.)
https://doi.org/10.17116/anaesthesiology202405172

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OBJECTIVE

To evaluate the effectiveness of perioperative anesthesia and intensity of surgical stress response depending on analgesia (ESP-block, prolonged epidural analgesia) in spinal surgery.

MATERIAL AND METHODS

We divided 96 patients into three groups: group 1 — general anesthesia with Erector Spinae Plane Block (ESP-block); group 2 — general anesthesia with prolonged epidural analgesia; group 3 (control) — general anesthesia without regional anesthetic techniques. The need for additional anesthesia, hemodynamics, pain intensity, serum cortisol and IL-6 were assessed.

RESULTS

Intraoperative hemodynamics was stable in all groups. Pain intensity was higher in the control group throughout the study. Intraoperative serum cortisol was normal in groups 1 and 2. After a day, cortisol decreased in group 1. After 3 postoperative days, serum cortisol increased in all groups. Intraoperative serum IL-6 was the highest in the control group (p=0.012). A day after surgery, the highest values were observed in the group with ESP block. The need for opioid analgesics was higher in group 3 (p=0.004). Urinary retention was registered in 2 (6%) patients of group 2.

CONCLUSION

Prolonged epidural analgesia and ESP-block provide effective analgesia and reduce severity of surgical stress response in spinal interventions.

Keywords:

ESP-block

prolonged epidural analgesia

spinal surgery

surgical stress response

Authors:

Morunova A.Yu.

Privolzhsky Research Medical University

ORCID: 0000-0003-4624-840X

Ezhevskaya A.A.

Privolzhsky Research Medical University

ORCID: 0000-0002-9286-4679

Prusakova Zh.B.

Privolzhsky Research Medical University

ORCID: 0009-0009-5481-5399

Zagrekov V.I.

Privolzhsky Research Medical University

ORCID: 0000-0001-8235-7705

Received:

10.03.2024

Accepted:

16.04.2024

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