Erector Spinae Plane Block for Pain

Overseen By Sena Ulucay, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University Hospitals Cleveland Medical Center

Must not be taking: High-dose opioids

Disqualifiers: Previous spine surgery, Metastatic cancer, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

32 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new method to reduce pain for individuals undergoing spine surgery. It uses a special numbing technique called the Erector Spinae Plane (ESP) Block, which delivers a mix of numbing and pain-relief medicines near the spine. The goal is to determine if this method can effectively manage post-surgery pain, reducing the need for other pain medications. Suitable participants are those planning to have lumbar spine fusion surgery and who can walk before their surgery. As an unphased trial, this study offers participants the chance to contribute to innovative pain management research.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it excludes patients who are taking 30 mg or more of morphine equivalent daily. It's best to discuss your specific medications with the trial team.

What prior data suggests that the Erector Spinae Plane Block is safe for spinal surgery patients?

Research has shown that the lumbar erector spinae plane (ESP) block is generally safe for pain relief. Studies have found that this method can reduce side effects such as nausea, vomiting, dizziness, and itching after surgery. It also leads to less bleeding during operations and does not extend surgery time.

Patients who received an ESP block required fewer opioids (strong painkillers) after surgery, reducing the risk of side effects from these drugs. Overall, the ESP block is well-tolerated, with participants often reporting less pain and greater satisfaction with their pain management. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike the standard pain management options for spinal surgery, such as opioids and general anesthetics, the lumbar Erector Spinae Plane (ESP) Block offers a more targeted approach to pain relief. This method involves injecting anesthetic near the spine, which can provide effective pain control with potentially fewer side effects than systemic drugs. Researchers are excited about the ESP Block because it may reduce the need for opioids, lowering the risk of addiction and other side effects, while also enhancing patient comfort and recovery after surgery.

What evidence suggests that the Erector Spinae Plane Block is effective for pain management in spinal surgery?

Research has shown that a lumbar erector spinae plane (ESP) block can reduce pain after spine surgery. In this trial, participants scheduled for spinal surgery will receive ESP block medications. Studies have found that an ultrasound-guided ESP block decreases the need for opioids during and after surgery, improving pain management and recovery within 24 hours. Another study found that ESP blocks can also lessen long-term pain after minimally invasive surgeries. Patients reported experiencing less nausea and vomiting after receiving the block. Overall, the ESP block appears promising for enhancing comfort and satisfaction after spine surgery. ^{2 4 6 7 8}

Who Is on the Research Team?

Salim Hayek, MD

Principal Investigator

University Hospitals Cleveland Medical Center

Are You a Good Fit for This Trial?

This trial is for individuals with peripheral neuropathy and pain who are undergoing spine surgery. Participants must be suitable for an ESP block, which involves a numbing medication and contrast dye injection. Specific inclusion or exclusion criteria aren't provided, but typically participants should not have conditions that would interfere with the procedure or assessment.

Inclusion Criteria

ASA status: I-III

I am between 21 and 75 years old.

I am scheduled for a spine fusion surgery of up to three levels.

Exclusion Criteria

Confirmed allergy to ropivacaine, dexmedetomidine or iohexol

Pregnancy

My kidney function is reduced.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Pre-surgery Preparation

ESP block is administered with ropivacaine, dexmedetomidine, and iohexol. QST procedure is conducted to assess numb areas.

1 hour

Surgery

Participants undergo lumbar spine fusion surgery. Baseline CT scan images are obtained, and the catheter is removed.

Surgery duration

Post-surgery Monitoring

Pain scores and pain medication usage are recorded over the next four days in the hospital.

4 days

Follow-up

Participants are monitored for safety and effectiveness after treatment, including assessment of pain and recovery quality.

4 days

What Are the Treatments Tested in This Trial?

Interventions

• Lumbar Erector Spinae Plan (ESP) Block

Trial Overview The study tests the effectiveness of combining ropivacaine (a numbing agent), dexmedetomidine (a non-narcotic pain medicine), and iohexol (contrast dye) in an ESP block before spine surgery. The QST procedure assesses numbness pre-surgery, while post-surgery pain scores and medication use are monitored.

How Is the Trial Designed?

Group I: Spinal Surgery Participants Experimental Treatment 4 Interventions

Participants scheduled for spinal surgery will have ESP block medications administered as per standard care along with contrast dye.

Who Is Running the Clinical Trial?

University Hospitals Cleveland Medical Center

Lead Sponsor

Trials

348

Recruited

394,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11218203/

The efficacy of lumbar erector spinae plane block for ... US-guided L-ESPB reduces intraoperative and 24 h postoperative opioid consumption and improves patients' QoR-15 scores at 24 h postoperatively.

2. nature.com nature.com/articles/s41598-025-03958-w

A randomized clinical trial of erector spinae plane block ... A recent study revealed that ESPB reduced chronic postsurgical pain for 3 months after minimally invasive thoracic surgery. For this reason, ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S0952818022000034

Analgesic efficacy of erector spinae plane block in lumbar ... ESPB provided effective postoperative analgesia resulting in better patient satisfaction and recovery with decreased postoperative nausea and vomiting.

4. journals.lww.com journals.lww.com/anesthesia-analgesia/fulltext/9900/erector_spinae_plane_block_in_multimodal_analgesia.1352.aspx

Erector Spinae Plane Block in Multimodal Analgesia After... This study evaluated the effect of bilateral ESPB on early postoperative pain and opioid use after lumbar spinal fusion surgery.

5. orthopedicreviews.openmedicalpublishing.org orthopedicreviews.openmedicalpublishing.org/article/124769-erector-spinae-plane-block-for-chronic-lumbosacral-pain-a-case-report

Erector Spinae Plane Block for Chronic Lumbosacral Pain Following the ESP block, the patient reported a significant reduction in his low back pain, with approximately 90% improvement in his pain ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10164397/

Efficacy and Safety of Erector Spinae Plane Block ... Our meta-analysis demonstrated that ESPB can reduce the incidence of postoperative nausea, vomiting, dizziness, and itching after lumbar spinal ...

7. nature.com nature.com/articles/s41598-025-13518-x

Effects of erector spinae plane block on intraoperative ... ESPB was associated with a significant reduction in IBPV and intraoperative blood loss without extending surgical time. Additionally, ESPB ...

8. frontiersin.org frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1330446/full

Efficacy of erector spine plane block in two different ... ESPB significantly reduced pain intensity at rest in both surgical approaches 48 h after surgery (p < 0.05). The need for postoperative fentanyl infusion was ...