EP101 The effects of retrolaminar block and erector spinae plane block on postoperative recovery quality and pain in lumbar spinal surgery

<h3>Background and Aims</h3> Regional anesthesia techniques are increasingly used as part of multimodal analgesia strategies to reduce postoperative pain and accelerate recovery after lumbar spinal surgery. This study compared the effects of erector spinae plane (ESP) block and retrolaminar block (RLB) on postoperative recovery quality and pain. <h3>Methods</h3> Eighty patients aged 18–75 years, classified as ASA I–III and scheduled for elective lumbar spinal surgery, were included in this prospective, randomized, double-blind study. Ethical approval was obtained, and the study was registered with ClinicalTrials.gov before the enrollment of the first patient. After obtaining verbal and written consent, patients were randomly assigned to the ESP or RLB group using computer-assisted randomization. Bilateral blocks were performed at the T10 level before surgery in both groups. The primary outcome was recovery quality measured by the QoR-40 score at 24 hours. Secondary outcomes included total opioid consumption and the patient‘s NRS pain scores. The number of PCA boluses, time to mobilization, discharge time, and side effects were also recorded. <h3>Results</h3> There was no significant difference between the groups in recovery quality at 24 hours postoperatively (p &gt; 0.05). Total tramadol consumption and the number of PCA button presses were significantly lower in the ESP group (p &lt; 0.05). NRS scores at rest were significantly lower in the ESP group at 12 and 24 hours (p &lt; 0.05). No differences were found between the groups regarding additional analgesia requirements, time to first mobilization, discharge time, or side effects. <h3>Conclusions</h3> Although ESP block provided superior postoperative pain control and reduced opioid consumption compared to RLB, this advantage did not reflect in the 24-hour recovery quality. Therefore, despite the strong analgesic efficacy of the ESP block, further studies are needed to compare its effectiveness on functional recovery.