Comparison of Erector Spina Block with Ropivacaine and Erector Spina Block with Ropivacaine and Epinephrine on Intraoperative Bleeding and Duration of Analgesia in Posterior Lumbar Spine Fusion Surgery

Comparison of Erector Spina Block with Ropivacaine and Erector Spina Block with Ropivacaine and Epinephrine on Intraoperative Bleeding and Duration of Analgesia in Posterior Lumbar Spine Fusion Surgery

Clinical trial with control and intervention group, single blind, on 64 patients, randomized with sealed envelope.

Patients referred to Luqman Hospital are divided into two intervention and control groups of 32 people by block randomization. After anesthesia with the same method, both groups will be placed in the prone position before the surgery under ultrasound guidance under bilateral erector spina block at the level of the surgical site. Paramedian sagittal ultrasound probe, about 2 cm outside the spinous processes, we find the transverse process on the same side. We insert the needle caudal to the cranial so that the tip of the needle hits the transverse process. If the needle site is suitable, 20 cc of ropivacaine 0.25% with 5 mic/ml of epinephrine will be injected in the intervention group and 20 cc of ropivacaine 0.25% in the control group. Isoflurane and opioid consumption ,bleeding, pain, in recovery, as well as at 1-6-12 and 24 hours after the operation are recorded.

Inclusion criteria : Patients 18-65 years old; Normal kidney and liver function; ASA score 1-2; Patient consent ; No history of allergies to local anesthetics; No drug addiction Exclusion criteria:, Increase the scope of surgery to more than three level ,time of surgery for more than 6 hours; No diabetes

The intervention group, after anesthesia and changing to the prone position, ,are subjected to erector spinae block with Ropivacaine-epinephrine, and the control group are subjected to block with Ropivacaine

Consumption of isofluran , opioids, pain score

Permuted Randomized Blocks :In this method, 10 random blocks are generated by computer. Each block includes 5 people in the intervention group and 5 people in the control group. The order of these people is randomly arranged by computer and people are assigned to groups in the same way. At the end of each block, a new block of 10 is produced and this process will continue until the final sample volume is reached.

Participants in the study are unaware of the groupings because the intervention is performed after anesthesia. The patient's clinical caregiver, the evaluator and recorder of the results, and the data analyzer are not aware of the grouping.