Scholarly Article
ANALGESIC EFFECT OF BILATERAL ULTRASOUND-GUIDED ERECTOR SPINAE PLANE BLOCK WITH 0.375% ROPIVACAINE IN LUMBAR SPINE SURGERY
Milind Pol, Vaijayanti Badhe
2026-07-23 · International Journal of Clinical and Biomedical Research · Sumathi Publications
Abstract
Background: Lumbar spine surgery is frequently followed by moderate-to-severe postoperative pain and substantial opioid exposure. The erector spinae plane block (ESPB) is an ultrasound-guided fascial plane block increasingly used as part of multimodal analgesia. This study evaluated perioperative haemodynamic trends and postoperative analgesia after bilateral ESPB with 0.375% ropivacaine in adults undergoing elective lumbar spine surgery. Methods: This prospective observational study included 32 adults with American Society of Anesthesiologists physical status I or II undergoing elective lumbar spine surgery under general anaesthesia. After induction, tracheal intubation, and prone positioning, bilateral ultrasound-guided ESPB was performed at the L3 vertebral level using 20 mL of 0.375% ropivacaine on each side. Intraoperative heart rate and arterial blood pressure were recorded serially. Postoperative pain was assessed using a visual analogue scale (VAS) for 24 hours. The duration of analgesia was defined as the interval from block administration to the first rescue analgesic requirement at VAS >4. Repeated haemodynamic measurements were evaluated using the Friedman test. Results: Serial heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure differed significantly across the recorded time points (all p<0.001), although clinically stable intraoperative trends were observed. The mean time to first rescue analgesia was 571.62 ± 32.74 minutes (median, 562.5 minutes; interquartile range, 550-600 minutes; range, 500-660 minutes). Postoperative VAS scores were low during the early recovery period and remained manageable during 24-hour follow-up. The Ramsay Sedation Scale score remained 1 after the immediate postoperative assessment, and no block-related complication was recorded. Conclusion: In this single-arm observational cohort, bilateral ultrasound-guided ESPB with 0.375% ropivacaine was associated with prolonged postoperative analgesia and clinically stable perioperative haemodynamic trends after lumbar spine surgery. Controlled studies are required before causal conclusions can be drawn regarding opioid-sparing efficacy or superiority over standard multimodal analgesia.
Keywords
Erector spinae plane block, Ropivacaine, Lumbar spine surgery, Postoperative analgesia, Regional anaesthesia, Haemodynamics.
Citation Details
International Journal of Clinical and Biomedical Research, Vol. 11, No. 3, pp. 77-83