Application Of Erector Spinae Plane Block With Ropivacaine In Patients Undergoing Percutaneous Transforaminal Endoscopic Discectomy

Objective:To investigate the feasibility of ultrasound-guided erector spinae plane block(ESPB)with lower concentrations of ropivacaine in patients undergoing percutaneous endoscopic discectomy and to compare the differences in clinical efficacy between the two groups with different concentrations,and ulteriorly summarize the local anesthetic dose suitable for the same sort of surgery.Method:A total of 40 adult patients undergoing percutaneous endoscopic discectomy in Yan’an Hospital Affiliated to Kunming Medical University from October 2020 to December 2020 were selected and randomly divided into two groups by digital randomization method.Patients in Group A received 0.375%ropivacaine 20ml(group A,n=20),and patients in group B received 0.25%ropivacaine 20ml(group B,n=20).All patients in both groups were under ultrasound-guided ESPB.After the pain sensation in the operation area is significantly relieved,the operation was started.And the duration of pain disappearance in the operation area was recorded.The NRS scores at different time points including tunneling(T1),free nerve root decompression(T2),suture(T3),and 24 hours after surgery(T4)were recorded,respectively.The patient’s satisfaction with anesthetic and analgesic services,the incidence of complications such as dizziness,nausea and vomiting,and puncture complement hematoma nerve injury lower extremity motor nerve block were followed up after surgery,and the Oswestry Disability Index(ODI)score was recorded.Results:Both concentrations of ropivacaine in this trial produced varying degrees of anesthetic effect on patients under surgeries.While the analgesic effect and patient satisfaction in group B were lower than those in group A.ESPB was not effective enough in lowering pain in patients undergoing L5/S1 surgery.In group B,5 patients received sufentanil and local injection of ropivacaine as rescue,another group this number is one.The extent of analgesia beyond the posterior axillary line was not observed before leaving the operating room in any of the patients included in the present trial.Conclusion:1.ultrasound-guided erector spinae plane block using 0.25%ropivacaine had a slower onset of action,poorer analgesic effect,and lower patient satisfaction compared with 0.375%concentration.2.1n percutaneous endoscopic discectomy,ultrasound-guided erector spinae plane block with 0.375%ropivacaine can produce satisfactory analgesic effect.3.EPSB can be used as an effective anesthetic modality in percutaneous endoscopic surgery.