A Comparative Study to Evaluate the Efficacy of Adding Ultrasound-guided Bilateral Erector Spinae Block to Standard Anaesthesia Care Versus General Anaesthesia in Patients Undergoing Single-level Transforaminal Lumbar Interbody Fusion Surgery: A Doub

Introduction: The erector spinae plane (ESP) block, introduced in 2016, is a fascial plane block gaining popularity for its analgesic efficacy in multiple cardiac, thoracic and abdominal surgeries. It involves injecting local anaesthetic deep into the erector spinae muscles. Multiple large retrospective and prospective studies have shown the efficacy of ESP blocks in various surgeries, and we determined to evaluate them in Spinal surgeries. Methods: This study evaluated the efficacy of erector spinae block in single-level lumbar fusion surgery. Pain scores, surgical field, opioid use and adverse effects were compared in a double-blind randomised controlled trial (RCT). The block group received 20 mL of 0.375% ropivacaine on each side and the control group received 20 mL of 0.9% normal saline. Results: The ESP block group showed lower pain scores in the post anaesthesia care unit (PACU) and up to eight hours postoperatively, with 82.4% requiring no additional analgesia, unlike the control group, where all patients needed supplements like tramadol or buprenorphine. Surgical field conditions, assessed using Boezaart’s grading scale, were significantly better up to 30 minutes after incision. Although blood loss differences were statistically significant ( P = .048), correlation was weak. Adverse effects, including constipation, nausea and drowsiness, were higher in the control group due to greater opioid use. Conclusion: The ultrasound-guided ESP block is a practical, feasible analgesic modality for lumbar spine surgeries, suitable for multimodal and opioid-sparing analgesia.