Erectus Nerve Block for Lumbar Spine Surgery

Centre Hospitalier Universitaire de Nīmes50 enrolled

Overview

: Spine surgery induced severe postoperative pain. Several techniques as intravenous multimodal analgesia have been proposed to reduce pain relief and morphine rescue over the first postoperative days. Regional anesthesia using the erectus nerve block is a simple infiltration across lamina of the vertebra: Ultrasound-guided posterior ramus of spinal nerve block for anesthesia and analgesia in lumbar spinal surgery This study compared erector nerve block with local anesthetic vs placebo to reduce pain and morphine rescue after lumbar spine surgery. The investigators hypothesized that eructor nerve block induced a large block from L1 to L5 that induced posterior nerve roots block anesthesia. This block reduced pain after surgery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

Conditions

Spine Surgery Pain Relief Morphine AdverseEvent

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * age\> 18years and \<80 years * lumbar spine surgery (2-4 levels) * posterior approach * ASA 1-3 Exclusion Criteria: * refusal * age \< 18yrs * \<50 kg and \>120 kg * pregnant * renal or hepatic severe desease * ASA 4 * no French speaking * emergency surgery * local or systemic infection * surgical resumption of the surgical site * surgery involving a thoracic approach * allergy to local anesthetics

Outcomes

Primary Outcomes

morphine consumption (mg)

Quantity administered in the post-interventional monitoring room and in hospitalization via a self-controlled morphine pump by the patient

Time frame: 24 Hours after surgery

Secondary Outcomes

Adverse events

Nausea, vomiting, confusion, urinary retention, hematoma, reintervention

Time frame: from surgery to 3 months

pain at rest and at movement: Visual Analogic scale

Visual Analogic scale of pain (0-10)

Time frame: Day 1 to Day 3, Day od hospital discharge and month 3

chronic pain: DN4 questionnaire

pain score as mesured with DN4 questionnaire

Time frame: Questionnaire DN4 at 3 months

Length of hospital stay

Number of day in hospital

Time frame: hospital length of stay, an average of 4 days

Length of stay in the post-intervention care unit

Number of minutes that patient stay in post intervention care unit in minutes

Time frame: Day 1

Patient Satisfaction: visual analogic scale

Patient satisfaction mesured with a visual analogic scale (0-10)

Time frame: Day of hospital discharge, an average of day 4

Patient Quality of life: EQ-5D Questionnaire

Patient Quality of life mesured with EQ-5D Questionnaire

Time frame: 3 months