{
  "abstract": "Background and Aims Surgical treatment of open spinal fixation is accompanied by severe pain during surgery and in the postoperative period. The most common used drugs for perioperative analgesia in these surgeries are opioids. Although opioids provide good analgesia, they are related to plenty side effects and complications from their use. New regional anesthetic techniques, such as ultrasound-guided blocks, as part of multimodal analgesia provide good perioperative analgesia, with significant reduce of use of opiates and their side effects.The primary objective of the study is to determine the effect of the Erector spinae plane block (ESB) as part of multimodal analgesia, and opioid anesthesia (OA) on intraoperative and postoperative analgesia in open spinal fixation operations. Secondary objectives: 1. To determine the total dose of opiates given in each of the groups during operation and postoperatively. 2. To examine the postoperative occurrence of dizziness, diplopia, nystagmus, hallucinations, nightmares in both groups. 3. To determine the incidence of postoperative nausea and vomiting in both groups.Methods The study was randomized, prospective, interventional clinical trial with a total of 70 patients, using two parallel groups of 35 patients each, scheduled for open spinal fixation. Group 1 (OG-opioid group): 35 patients who received intermittent opioid – fentanyl as analgesia, Group 2 (ESPBMM): in 35 patients, erector spinae muscle sheath block (ESPB) was administered with multimodal anesthesia, and postoperative low dose ketamine infusion.Results The combination of ESP block and multimodal analgesia provided excellent intraoperative analgesia and good postoperative analgesia compared to opioid group. There was significantly decreased use of opiates in the perioperative period in the ESP block with multimodal analgesia group, as well as a lower incidence of postoperative nausea and vomiting.Conclusions The use of the ESPB as part of multimodal analgesia in open spinal fixation operations is safe and provides good perioperative analgesia.",
  "authors": [
    {
      "affiliations": [
        "Anesthesia, UK Toariluc – Karil, Skopje, North Macedonia"
      ],
      "name": "Aleksandar Dimitrovski"
    },
    {
      "affiliations": [
        "Anesthesia, University Clinic for Anesthesia, Reanimation and Intensive, Skopje, North Macedonia"
      ],
      "name": "Biljana Kuzmanovska"
    },
    {
      "affiliations": [
        "Anesthesia, University Clinic for Anesthesia, Reanimation and Intensive, Skopje, Germany"
      ],
      "name": "Marija Toleska"
    },
    {
      "affiliations": [
        "Anesthesia, University Clinic for Anesthesia, Reanimation and Intensive, Skopje, North Macedonia"
      ],
      "name": "Blagica Petrovska"
    },
    {
      "affiliations": [
        "University Clinic for Thoracic surgery – Skopje, Skopje, North Macedonia"
      ],
      "name": "Natasha Toleska"
    },
    {
      "affiliations": [
        "Anesthesia, University Clinic for Anesthesia, Reanimation and Intensive, Skopje, North Macedonia"
      ],
      "name": "Simona Nikolovska"
    },
    {
      "affiliations": [
        "Anesthesia, University Clinic for Anesthesia, Reanimation and Intensive, Skopje, North Macedonia"
      ],
      "name": "Marina Temelkovska"
    }
  ],
  "title": "OP67 Analgesic effect of the erector spinae plane block as a part of multimodal anesthesia during surgery of open fixation of the thoraco-lumbar spine",
  "uid": "5eeb64c1-ac63-5ab7-b9a1-e1960bbfe06a"
}