Meizhu Zhao, Mingyang Gao, Xin Zhang, Qi Zhou, Peixia Yu, Chunxiao Liu, Xueyin Song, Xin Shan, Jianglong Dong, Zhihua Li, Qiujun Wang

Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People’s Republic of China

Correspondence: Zhihua Li, Email mzlzh2013@163.com Qiujun Wang, Email 37000628@hebmu.cn

Purpose: This retrospective study aimed to explore the effect of erector spinae plane block (ESPB) on the gastrointestinal function in patients after traumatic lumbar fracture surgery and the effects of different levels of block approach.
Patients and Methods: Clinical data were retrospectively analyzed from electronic medical records of patients who underwent traumatic lumbar spine fracture surgery (September 2022-June 2023). Eligible patients were divided into three groups: group L (bilateral ESPB at L3 level), group T (bilateral ESPB at T12 level) and group C (no block). The primary outcomes were the incidence and the time of occurrence postoperative bloating. We also recorded the time of the first flatus and bowel movement, postoperative nausea and vomiting (PONV), gastrointestinal medications, enema, intraoperative opioid dosage, number of rescue analgesia within 48 h postoperatively, visual analogue scale (VAS) scores at 24 h and 48 h postoperatively, inflammatory mediators, complications and hospital length of stay (LOS).
Results: 145 patients were included, including 32 in group L, 33 in group T and 80 in group C. Patients in group L and T experienced less bloating compared to group C (P < 0.05). Patients in group T presented bloating significantly later than group L (log rank P < 0.0167). Patients in group L and group T had a significantly shorter time to first flatus and bowel movement, lower incidence of PONV, gastrointestinal medications and enema, and a lower dose of opioid and VAS scores at 24 h postoperatively compared to group C (all P < 0.05), the difference between group L and T was not statistically significant.
Conclusion: Bilateral ESPB improved postoperative gastrointestinal function in patients with traumatic lumbar spine fracture, where the T12 level of ESPB was more favorable than the L3 level.

Keywords: erector spinae plane block, postoperative ileus, spine fracture, trauma