Effect of Ultrasound-guided Erector Spinae Plane Block using Levobupivacaine on Postoperative Analgesia in Thoracic and Lumbar Spine Surgeries: A Prospective Observational Study

Introduction: Postoperative pain management in thoracic and lumbar spine surgeries is crucial for preventing complications, promoting early mobilisation, and improving patient outcomes. The Erector Spinae Plane (ESP) block, an emerging regional anaesthesia technique, shows promising results in the management of postoperative pain by targeting the dorsal and ventral rami of the spinal nerve, thus providing both somatic and visceral analgesia. Aim: To evaluate the efficacy of ultrasound-guided ESP block using levobupivacaine for postoperative pain relief and reduction in analgesic requirements in thoracic and lumbar spine surgeries. Materials and Methods: This prospective observational study was conducted at a tertiary care centre from June 2020 to November 2021. Fifty-two patients, aged 18-65 years, undergoing thoracic or lumbar spine surgeries were included. Group E (n=26) received an ESP block with levobupivacaine, while Group C (n=26) did not. Postoperative pain was assessed using the Visual Analogue Scale (VAS) at 1, 4, 6, 12, and 24 hours postoperatively. The requirement for rescue analgesia and adverse events, including haemodynamic stability, were recorded. Statistical analysis was performed using the independent t-test and Chi-square test for continuous and categorical variables, respectively, with a p-value <0.05 considered statistically significant. Results: Group E demonstrated significantly lower VAS scores at all postoperative intervals (p<0.001). Patients in Group E required less rescue analgesia compared to Group C (7.7% vs. 53.8%, p<0.001). Haemodynamic stability was maintained more effectively in Group E, with more stable haemodynamic parameters (p<0.001). Conclusion: Ultrasound-guided ESP block with levobupivacaine is an effective method for reducing postoperative pain and analgesic requirements in thoracic and lumbar spine surgeries. The technique also contributes to better haemodynamic stability during the perioperative period.