Erector spinae block with liposomal bupivacaine for analgesia in lumbar fusion surgery

WANG Zhang-hong; ZHOU Sen; ZHU Meng-die; JIANG Yi

doi:10.13820/j.cnki.gdyx.20241767

Abstract：Objective To compare the efficacy of liposomal bupivacaine(LB)and levobupivacaine in erector spinae plane block(ESPB)for lumbar fusion surgery and evaluate the safety and effectiveness of LB in early postoperative analgesia,providing evidence for clinical low-opioid analgesia strategies.Methods Sixty patients scheduled for elec-tive lumbar fusion surgery were randomized into two groups:the liposomal bupivacaine group(LB group,n=30)and the levobupivacaine group(B group,n=30).Both groups received ESPB after general anesthesia.The LB group received 20 mL liposomal bupivacaine(266 mg)+40 mL normal saline,while the B group received 20 mL levobupivacaine(150 mg)+40 mL normal saline,with 20 mL injected per side.Pain numeric rating scale(NRS)scores were recorded at PACU(post-anesthesia care unit),and at 6,24,48,and 72 hours postoperatively.Perioperative sufentanil consump-tion,rescue analgesia,patient-controlled analgesia(PC A)pump usage,and postoperative adverse events were also re-corded.Results The LB group exhibited significantly lower movement NRS scores at PACU,24,48,and 72 hours post-operatively[1(1,2)、3(3,4)、3(2,3)、2(2,3)]compared to the B group[2(1,3)、4(4,4)、3(2.75,3)、3(2,3)](P＜0.05).Resting NRS scores were not significantly different between the groups(P＞0.05).The LB group consumed less sufentanil intraoperatively and at 24 and 48 hours postoperatively[(27.33±3.88)μg,(76.2±10.98)µg,(112.38±18.46)μg]than the B group[(31.50±4.76)µg,(83.52±9.36)µg,(121.98±15.91)µg,P＜0.05].PCA pump parameters,including total presses,effective presses,and analgesic drug consumption at 24 and 48 hours,were significantly lower in the LB group compared to the B group(P＜0.05).There were no significant differences in PACU stay time,hospitalization duration,or adverse events between the two groups(P＞0.05).Conclusion Liposo-mal bupivacaine can be safely used in lumbar fusion surgery,providing effective analgesia for up to 72 hours postoperative-ly while reducing perioperative opioid consumption,thus promoting early recovery.