Intraoperative ESP block yields higher postoperative recovery scores than preoperative block in lumbar disk hernioplasty
This single-blind randomized controlled trial enrolled 100 adults (ASA I-III) undergoing elective single-level lumbar disk hernioplasty. Patients were randomized to receive an erector spinae plane block either before anesthesia induction (preoperative) or after induction (intraoperative). The primary outcome was not explicitly stated, but secondary outcomes included Quality of Recovery-40 (QoR-40) and State-Trait Anxiety Inventory (STAI) scores.
The main finding was a statistically significant difference in the total QoR-40 score, favoring the intraoperative block group (P = .02). However, the authors determined this difference reached only the threshold for minimal clinical significance. The intraoperative block group also had a significantly higher score on the QoR-40 emotional status subparameter. No significant differences were found between groups for other QoR-40 subdimensions (physical comfort, independence, support, pain) or for postoperative anxiety (STAI-1) scores.
Safety and tolerability data were not reported. Key limitations include the single-blind design, a modest sample size of 100, and the lack of a reported primary outcome. The absence of safety data and details on follow-up duration are notable gaps. For practice, this evidence suggests the procedural timing of an ESP block may have a small, statistically detectable effect on patient-reported recovery quality, particularly emotional status, in this specific surgical context, but the clinical relevance of this difference is uncertain.
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