A randomized clinical trial of erector spinae plane block and chronic pain after posterior lumbar surgery

The effectiveness of erector spinae plane block (ESPB) in preventing chronic pain after posterior lumbar surgery remains controversial. The primary hypothesis of this study was that ESPB reduces the incidence of chronic pain for 3 months after posterior lumbar surgery. In this prospective, randomized, parallel-group study, a total of 120 patients who underwent open posterior lumbar decompression surgery under general anesthesia were randomized into two groups. The ESPB group underwent preoperative bilateral ESPB, and the control group did not receive the block. The primary outcome was the incidence of chronic pain at 3 months after surgery. The secondary outcomes included postoperative morphine consumption, time to first ambulation after surgery, length of hospital stay and incidence of chronic pain at 6 months after surgery. At 3 months, chronic pain was reported in 21/56 (37.5%) and 28/58 (48.3%) patients in the ESPB and control groups, respectively (OR = 1.6; 95% CI, 0.7-3.3; p = 0.245). The ESPB group had less postoperative morphine consumption (p < 0.001) and a shorter time to first ambulation after surgery (p = 0.006) than the control group did. The length of hospital stay was similar. There was also no difference in the incidence of chronic pain at 6 months. ESPB did not reduce the incidence of chronic pain after posterior lumbar surgery, but it did facilitate early recovery after surgery.