{
  "abstract": "Background and Aims Micro-lumbar discectomy (MLD) is increasingly performed as a day-case procedure due to advancements in minimally invasive techniques. Effective postoperative analgesia remains critical for early ambulation and timely discharge. Erector spinae plane block (ESPB) is a promising regional technique with growing evidence supporting its efficacy in spine surgeries. The aim of this study is to evaluate the effectiveness of ESPB in reducing postoperative pain and opioid consumption in day-case MLD surgery under an ERAS framework.Methods This prospective case-control study included 60 patients (ASA: I – III) undergoing elective single level MLD. Patients were divided into two groups: ERAS-only (n=30) and ESPB + ERAS (n=30). ESPB group received a single-injection ultrasound-guided ESPB at the L3 vertebral level using 30 mL of 0.25% bupivacaine prior to induction. All patients of both groups followed ERAS protocol: preoperatively, oral paracetamol 1 g and pregabalin 25 mg; intraoperatively, IV dexamethasone 5 mg, propofol and remifentanil via TCI; postoperatively, IV diclofenac 75 mg single dose, followed by oral NSAIDs and paracetamol. Pethidine 1 mg/kg IM used as rescue analgesia. Primary outcomes were VAS scores at 2, 6, 12, and 24 hours; secondary outcomes included opioid use, time to rescue analgesia, and discharge timing.Results Pain scores were significantly lower in the ESPB group at all time points (VAS at 2 h: 1.3 ± 0.7 vs 3.2 ± 1.1; p < 0.001). Opioid use was significantly reduced (45 ± 28 mg vs 110 ± 35 mg; p < 0.001). Rescue analgesia was delayed in the ESPB group (8 vs 3 hours; p = 0.004). No block-related complication was observed. 92% patients of ESPB + ERAS group were discharge on the same day, while 57% of ERAS only group.Conclusions ESPB significantly improves postoperative analgesia, reduces opioid requirement, and enhances early recovery when integrated into ERAS for day-case MLD.",
  "authors": [
    {
      "affiliations": [
        "Anaesthesia, Evercare Hospital, Dhaka, Dhaka, Bangladesh"
      ],
      "name": "Lutful Aziz"
    },
    {
      "affiliations": [
        "Specialist, Anaesthesia and Pain Medicine, Evercare Hospital Dhaka, Dhaka, Bangladesh"
      ],
      "name": "Fatema Akter"
    },
    {
      "affiliations": [
        "Associate Consultant, Anaesthesia and Pain Medicine, Evercare Hospital Dhaka, Dhaka, Bangladesh"
      ],
      "name": "Masrufa Hossain"
    },
    {
      "affiliations": [
        "Associate Consultant, Anaesthesia and Pain Medicine, Evercare Hospital Dhaka, Dhaka, Bangladesh"
      ],
      "name": "Salah Uddin Al Azad"
    },
    {
      "affiliations": [
        "Consultant Anaesthetist , The Hillingdon Hospital NHS Foundation Trust, Uxbridge, UK, 35, Bridge Close, Cippenham, Slough, Berkshire, UK"
      ],
      "name": "Golam Ferdous Alam"
    },
    {
      "affiliations": [
        "Specialty Registrar – Anaesthetics, George Eliot Hospital, NHS trust, UK, 47, Merevale Avenue, Nuneaton, Warwickshire, UK"
      ],
      "name": "Nahida Parveen Nimmi"
    }
  ],
  "title": "OP49 To evaluate the effectiveness of erector spinae block for micro lumber discectomy in day case surgery",
  "uid": "2f8e8202-fd89-5300-81df-f341375b930d"
}