Retrolaminar Versus Erector Spinae Plane Block for perioperative analgesia in Posterior Lumber Spine Discectomy

Background: Significant postoperative pain following lumbar spine surgery necessitates the use of opioids throughout the surgical period, delayed anesthetic recovery, and postoperative morbidity. Although it has a lot of adverse effects, non-opioid analgesic strategies are crucial for preventing its consequences. In posterior Lumber Spine discectomy procedures, the roles of Erector Spinae Plane block (ESPB) and Retrolaminar block (RLB) in multimodal postoperative analgesia and improved recovery are significant. Thus, we aimed to compare effectiveness of ESPB and ultrasound-guided RLB in minimizing perioperative discomfort during posterior lumber spine discectomy procedures. Methods: This comparative study was conducted in department of anesthesia, intensive care, and pain management in Zagazig University Hospitals on 75 patients who underwent elective posterior lumber spine discectomy. Patients were allocated into three equal groups: Control group C: received opioids analgesia with induction of anesthesia in the form of intravenous fentanyl, Retrolaminar group R: patients received RLB after induction of anesthesia and before operation and ESPS group E: The patients received Lumbar ESPB after induction of anesthesia and before operation. Results: There was significant reduction in intraoperative fentanyl consumption and incidence of nausea in both ESPB and retrolaminar groups compared to the control group. Patient satisfaction scores were significantly higher in both ESPB, and RLB compared to the controls. There were no significant differences between ESPB and RLB in terms of analgesic efficacy, opioid consumption, or patient satisfaction. Conclusion: Both ESPB and RLB provide effective analgesia, reduce opioid consumption, and improve patient satisfaction in patients undergoing elective posterior lumbar spine discectomy.