Abstract

Background

Spine surgery is associated with considerable postoperative pain and can be challenging to treat. A loco-regional technique suitable for spine surgery should cover the dorsal root of the spinal nerves at the levels where surgery is performed. The erector spinae block is a loco-regional technique with promising results and was recently described at the thoracic level. There are no randomized trials of this technique on a lumbar level. This study tests the hypothesis that the 24-h postoperative morphine consumption is significantly lower in patients undergoing posterior lumbar inter-body fusion surgery with a lumbar erector spinae (LUMBES) block when compared with a sham block.

Methods

This prospective randomized double-blind multicenter study will randomly allocate 80 adult patients undergoing elective posterior lumbar inter-body fusion surgery during general anesthesia to one of two groups as follows: (1) bilateral erector spinae block (20 mL 0.25% levobupivacaine) or (2) bilateral sham block (20 mL NaCl 0.9%). Our primary endpoint is 24-h postoperative morphine consumption. Secondary endpoints include 72-h morphine consumption, intraoperative sufentanil dosage, postoperative pain scores at regular time intervals both at rest and during movement, time to first postoperative mobilization, and the Quality of Recovery 40 survey score.

Discussion

The LUMBES trial is a pragmatic clinical study that will provide evidence of whether a bilateral lumbar erector spinae block is effective in reducing 24-h postoperative morphine consumption in patients undergoing lumbar inter-body fusion surgery. If this hypothesis is confirmed, this finding could contribute to more widespread implementation of this technique.

Trial registration

Local ethics committee B300201837508, ClinicalTrials.gov identifier: NCT03825198. Registered on 31 Jan 2019.

Details

Title
A prospective randomized double-blind trial of the efficacy of a bilateral lumbar erector spinae block on the 24h morphine consumption after posterior lumbar inter-body fusion surgery
Author
Breebaart, M. B. 1   VIAFID ORCID Logo  ; Van Aken, D. 2 ; De Fré, O. 3 ; Sermeus, L. 3 ; Kamerling, N. 4 ; de Jong, L. 5 ; Michielsen, J. 6 ; Roelant, E. 7 ; Saldien, V. 3 ; Versyck, B. 8 

1  Antwerp University Hospital, Department of Anaesthesia, Edegem, Belgium (GRID:grid.411414.5) (ISNI:0000 0004 0626 3418); University of Antwerp, Faculty of Medicine and Health Sciences, Wilrijk, Belgium (GRID:grid.5284.b) (ISNI:0000 0001 0790 3681) 
2  AZ Klina, Department of Anaesthesia, Brasschaat, Belgium (GRID:grid.420031.4) (ISNI:0000 0004 0604 7221) 
3  Antwerp University Hospital, Department of Anaesthesia, Edegem, Belgium (GRID:grid.411414.5) (ISNI:0000 0004 0626 3418) 
4  Antwerp University Hospital, Department of Neurosurgery, Edegem, Belgium (GRID:grid.411414.5) (ISNI:0000 0004 0626 3418) 
5  Klina Hospital Brasschaat, Department of Neurosurgery, Brasschaat, Belgium (GRID:grid.411414.5) 
6  Antwerp University Hospital, Department of Orthopaedics, Edegem, Belgium (GRID:grid.411414.5) (ISNI:0000 0004 0626 3418) 
7  Antwerp University Hospital, University of Antwerp, Clinical Trial Center (CTC), CRC Antwerp, Edegem, Belgium (GRID:grid.411414.5) 
8  University of Antwerp, Faculty of Medicine and Health Sciences, Wilrijk, Belgium (GRID:grid.5284.b) (ISNI:0000 0001 0790 3681); Catharina Ziekenhuis, Department of Anaesthesia, Eindhoven, Netherlands (GRID:grid.413532.2) (ISNI:0000 0004 0398 8384) 
Pages
441
Publication year
2019
Publication date
Dec 2019
Publisher
Springer Nature B.V.
e-ISSN
17456215
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s13063-019-3541-y
ProQuest document ID
2795328255
Copyright
© The Author(s). 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.