Abstract :
Background: Spine surgeries are notorious for postoperative pain and delayed early rehabilitation. Various modalities are used to achieve analgesia in post-spinal surgery. Recently, the Erector Spinae Plane (ESP) block has improved the outcome of analgesia in various abdominal and thoracic surgeries.
Aim and Objectives: To compare the effects of Ropivacaine versus Nalbuphine in ESP block. Also, various postoperative outcomes.
Materials and Methods: This prospective randomised study involved 40 patients posted for elective cervical spine instrumentation surgery and classified as American Society of Anaesthesiologists (ASA) grade I or II. Patients were divided into two groups. Group R received 20 ml of 0.2% Ropivacaine, and Group N was administered 20 mg of Nalbuphine diluted in 20 ml of normal saline on both sides. Following the induction of anaesthesia, patients were positioned prone, and ESP block was performed at the C7-T1 level under sterile conditions.
Statistical Analysis: Data collection and formulation were analysed using ANOVA, Student’s t-test, and Paired t-test. The statistical analysis was conducted with SPSS version 21 for Windows. P value of < 0>.
Result: Group R receiving Ropivacaine for ESP block showed a significant postoperative pain reduction for the first 8 hours (P = 0.02), and the total analgesic consumption was lower in Group R compared to Group N (90 ± 160.15 versus 90 ± 160.15). The mean time for the first rescue analgesics was 189.72 vs 120.24 minutes in Group R & N, respectively (P = 0.03). The total number of patients requesting rescue analgesics was lower in Group R: 4 (40%) vs 11 (55%). Side effects were similar between the two groups and not significant.
Conclusion: ESP block is a safe and effective postoperative pain relief method in spine surgeries. Ropivacaine provided effective pain relief with prolonged time to rescue analgesia. At the same time, Nalbuphine has shown effective analgesia with an acceptable safety profile as a sole agent in ESP blocks. However, mild sedation was observed and should be factored into clinical decision-making.
Keyword :
Spine instrumentation surgery, Erector spinae plane block, Analgesia, Ropivacaine, Nalbuphine.