Effects of Erector Spinae Plane Block on Postoperative Pain Following Lumbar Fusion Surgery

University of Massachusetts, Worcester66 enrolled

Overview

The purpose of this study is to determine if the method for injecting local anesthesia affects patients' pain and opioid usage after surgery. The investigators will compare subcutaneous anesthesia, injections of anesthesia under the skin, to a method called erector spinae plane block (ESPB). An ESPB injection involves placing local anesthesia along the muscles and bones in the back, using a special type of x-ray called fluoroscopy for guidance. The Investigators will use patient reported outcomes (PROs) and track subjects' opioid usage to find out if there is a difference between ESPB and subcutaneous anesthesia. The investigators hypothesize that patients who get ESPB injections will use less opioids and report less pain after lumbar fusion surgery compared to patients who receive subcutaneous anesthesia injections.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Fusion of Spine, Lumbar Region Anesthesia, Local Pain, Postoperative

Interventions

Erector Spinae Plane BlockPROCEDURE

The erector spinae plane block (ESPB) is a method for injecting local anesthesia to reduce pain related to a surgical procedure. The anesthesia is theorized to spread along the paraspinal fascia and anesthetize a larger area, resulting in patients reporting less pain and using less opioids postoperatively.

Subcutaneous AnesthesiaPROCEDURE

Subcutaneous anesthesia injection involves placement of local anesthesia under the skin around the surgical incision. This is thought to reduce pain from the incision site postoperatively.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * The individual has signed and dated a study specific informed consent form approved by the Institutional Review Board at UMMHC. * The individual is at least 18 years of age. * The individual is skeletally mature (over the age of 18). * The patient is scheduled for a one or two level lumbar spinal fusion. Exclusion Criteria: * Patients unable to consent for themselves. * Pregnant women. * Non-English speaking subjects. * Prisoners. * Spinal fusion procedures for a diagnosis of fracture, tumor, and/or infection. * Patients who have used greater than 150 morphine milligram equivalents of opioids in the month prior to their operation. * Patients with a body mass index (BMI) of 40 or greater.

Outcomes

Primary Outcomes

MOS 36 Item Short Form Health Status Survey (SF-36)

Questionnaire related to a patient's general health, bodily pain, physical function, and mental health. Scoring includes eight scaled scores, which are the weighted sums of the questions in their section. Scales are converted into a 0-100 scale. The lower the score the more disability. The higher the score the more functionality and therefore indicating better outcome.

Time frame: 3 months

Oswestry Disability Index

Questionnaire related to a patient's back pain and its impact on their day-to-day activities. There are 10 questions, each weighted from 0-5 points. The point total of each question is added together to give a final scaled score ranging from 0-50. Lower scores near 0 are indicative of better outcome and less disability, while higher scores near 50 indicate worse outcomes and more disability.

Time frame: 3 months

Postoperative Opioid Usage

This is a tracking sheet for the amount of opioid medications used in the first 2 weeks of postoperative recovery.

Time frame: 2 weeks