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Comparison of ultrasound-guided erector spinae plane block and retrolaminal block combined with general anesthesia for patients undergoing vertebral surgery
Author(s): 
Pages: 289-293
Year: Issue:  3
Journal: Journal of Clinical Anesthesiology

Keyword:  Erector spinae plane blockRetrolaminal blockPosterior approach vertebral surgeryUltrasound-guidedPosterior ramus of spinal nerveVAS score;
Abstract: Objective To compare the clinical effects of ultrasound-guided erector spinae plane block(ESPB) and retrolaminal block(RLB) during posterior approach vertebral surgery. Methods Sixty patients, 35 males and 25 females, aged 45-65 years, BMI 18-32 kg/m~2, ASA physical status Ⅰ or Ⅱ, scheduled for elective posterior approach vertebral surgery from May 2017 to January 2018, were included and randomly divided into three groups(n = 20): group ESPB, group RLB and control group(group C). Both of the two trial groups were ultrasound-guided using parasagittal in-plane method before surgery in prone position except for group C. General anesthesia was applied in all three groups. 20 ml of 0.4% ropivacaine was injected into the posterior surface of transverse process in group ESPB or the posterior surface of laminar in group RLB. Sufentanil, remifentanil and cisatracurium consumption, urine volume, blood loss, extubation time and VAS score at 4, 12, 24, 48 h after operation were recorded. The adverse reactions such as pain, swelling and infection were recorded within 48 hours after operation in group ESPB and group RLB.Results Comparing with group C, both of the group ESPB and group RLB had a significant decrease in sufentanil, remifentanil, and cisatracurium consumption(P < 0.05), a similar urine volume and blood loss, a similar extubation time, and a prominent reduced VAS score at 4, 12, 24, 48 h after operation(P < 0.01). No pain, swelling or infection of the puncture site occurred within 48 hours after surgery in any of the two block groups. Conclusion Both ultrasound-guided bilateral ESPB and RLB combined with general anesthesia significantly decrease the opioid consumption and muscle relaxant consumption without impact on urine volume, blood loss and extubation time during posterior approach vertebral surgery, and provide satisfactory postoperative analgesia.
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