Combination of Bilateral Erector Spinae Plane Block and a Continuous Low-Dose Epidural Morphine Infusion for Perioperative Analgesia Following Major Lumbar Spine Surgery—A Case Series
Pain management utilizing appropriate regional techniques is vital to enhance recovery following major spine surgery. Regional techniques are increasingly used for analgesia following major lumbar spine surgery. This preliminary study describes a combination of two regional techniques for perioperat...
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| Series: | Journal of Neuroanaesthesiology and Critical Care |
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| author | Ramamani Mariappan Nandi V. Basavaraju Wilson P. D'Souza Sharon K. Chandana Krishnaprabhu Raju |
| author_facet | Ramamani Mariappan Nandi V. Basavaraju Wilson P. D'Souza Sharon K. Chandana Krishnaprabhu Raju |
| author_sort | Ramamani Mariappan |
| collection | DOAJ |
| description | Pain management utilizing appropriate regional techniques is vital to enhance recovery following major spine surgery. Regional techniques are increasingly used for analgesia following major lumbar spine surgery. This preliminary study describes a combination of two regional techniques for perioperative analgesia following major lumbar spine surgery. Thirteen patients underwent lumbar decompressive surgery with fusion using a standard anesthesia technique. All patients received bilateral single-shot erector spinae plane block (ESPB) using ropivacaine with dexmedetomidine before the surgical incision for intraoperative analgesia and continuous low-dose epidural morphine via an intraoperatively placed epidural catheter at the end of surgery for postoperative analgesia. The total intraoperative fentanyl and morphine requirement was very low. The postoperative pain score (Numerical Rating Scale) ranged from 0 to 4 at various points during the first 48 hours after surgery. The mean ambulation time and duration of hospital stay were 2.07 ± 0.34 and 4.84 ± 2.07 days, respectively. Three out of 13 patients (23%) developed postoperative nausea and vomiting. The combination of bilateral single-shot ESPB and continuous low-dose epidural opioid infusion via an intraoperatively placed epidural catheter provides excellent perioperative analgesia for patients undergoing major lumbar spine surgery. |
| format | Article |
| id | doaj-art-e568ec8bf9044649bf3e4ffdaffc9da0 |
| institution | OA Journals |
| issn | 2348-0548 2348-926X |
| language | English |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
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| series | Journal of Neuroanaesthesiology and Critical Care |
| spelling | doaj-art-e568ec8bf9044649bf3e4ffdaffc9da02025-08-20T02:25:03ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Neuroanaesthesiology and Critical Care2348-05482348-926X10.1055/s-0044-1801364Combination of Bilateral Erector Spinae Plane Block and a Continuous Low-Dose Epidural Morphine Infusion for Perioperative Analgesia Following Major Lumbar Spine Surgery—A Case SeriesRamamani Mariappan0Nandi V. Basavaraju1Wilson P. D'Souza2https://orcid.org/0000-0002-9936-4941Sharon K. Chandana3Krishnaprabhu Raju4https://orcid.org/0000-0002-2644-7201Department of Neuro Anesthesia, Christian Medical College, Vellore, Tamil Nadu, IndiaDepartment of Neuro Anesthesia, Christian Medical College, Vellore, Tamil Nadu, IndiaDepartment of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, IndiaDepartment of Neuro Anesthesia, Christian Medical College, Vellore, Tamil Nadu, IndiaDepartment of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, IndiaPain management utilizing appropriate regional techniques is vital to enhance recovery following major spine surgery. Regional techniques are increasingly used for analgesia following major lumbar spine surgery. This preliminary study describes a combination of two regional techniques for perioperative analgesia following major lumbar spine surgery. Thirteen patients underwent lumbar decompressive surgery with fusion using a standard anesthesia technique. All patients received bilateral single-shot erector spinae plane block (ESPB) using ropivacaine with dexmedetomidine before the surgical incision for intraoperative analgesia and continuous low-dose epidural morphine via an intraoperatively placed epidural catheter at the end of surgery for postoperative analgesia. The total intraoperative fentanyl and morphine requirement was very low. The postoperative pain score (Numerical Rating Scale) ranged from 0 to 4 at various points during the first 48 hours after surgery. The mean ambulation time and duration of hospital stay were 2.07 ± 0.34 and 4.84 ± 2.07 days, respectively. Three out of 13 patients (23%) developed postoperative nausea and vomiting. The combination of bilateral single-shot ESPB and continuous low-dose epidural opioid infusion via an intraoperatively placed epidural catheter provides excellent perioperative analgesia for patients undergoing major lumbar spine surgery.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1801364epidural analgesiaerector spinae plane blocklumbar spine surgeryopioidspostoperative analgesia |
| spellingShingle | Ramamani Mariappan Nandi V. Basavaraju Wilson P. D'Souza Sharon K. Chandana Krishnaprabhu Raju Combination of Bilateral Erector Spinae Plane Block and a Continuous Low-Dose Epidural Morphine Infusion for Perioperative Analgesia Following Major Lumbar Spine Surgery—A Case Series Journal of Neuroanaesthesiology and Critical Care epidural analgesia erector spinae plane block lumbar spine surgery opioids postoperative analgesia |
| title | Combination of Bilateral Erector Spinae Plane Block and a Continuous Low-Dose Epidural Morphine Infusion for Perioperative Analgesia Following Major Lumbar Spine Surgery—A Case Series |
| title_full | Combination of Bilateral Erector Spinae Plane Block and a Continuous Low-Dose Epidural Morphine Infusion for Perioperative Analgesia Following Major Lumbar Spine Surgery—A Case Series |
| title_fullStr | Combination of Bilateral Erector Spinae Plane Block and a Continuous Low-Dose Epidural Morphine Infusion for Perioperative Analgesia Following Major Lumbar Spine Surgery—A Case Series |
| title_full_unstemmed | Combination of Bilateral Erector Spinae Plane Block and a Continuous Low-Dose Epidural Morphine Infusion for Perioperative Analgesia Following Major Lumbar Spine Surgery—A Case Series |
| title_short | Combination of Bilateral Erector Spinae Plane Block and a Continuous Low-Dose Epidural Morphine Infusion for Perioperative Analgesia Following Major Lumbar Spine Surgery—A Case Series |
| title_sort | combination of bilateral erector spinae plane block and a continuous low dose epidural morphine infusion for perioperative analgesia following major lumbar spine surgery a case series |
| topic | epidural analgesia erector spinae plane block lumbar spine surgery opioids postoperative analgesia |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1801364 |
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