RecruitingNAINTERVENTIONAL

Effect of Erector Spinae (ESP) Block on Opioid Reduction and Enhanced Recovery After Posterior Cervical Spine Surgery

Patients often have a lot of pain after neck surgery, which can make it hard to move around and get better. This study is exploring a different approach to pain relief, focusing on something called an Erector Spinae (ESP) block. This block involves a local anaesthetic injection to specific nerves in the back. We're comparing it to an injection with a dummy substance (placebo) to understand how well it works. The main goal is to see if an ESP block can reduce the amount of strong pain medication (like opioids) needed after surgery, which can have unwanted side effects. Ultimately, we hope it can lead to a quicker and more comfortable recovery for patients.

At a glance

Status

Recruiting

Phase

Sponsor

University Health Network, Toronto

Enrolment target

Start

17 Feb 2020

Estimated completion

30 Dec 2025

Postoperative Pain

What is this study about?

Having surgery on your spine, especially your neck, can often lead to considerable pain afterwards. This pain can make it difficult to get out of bed, move around, and do the exercises that are so important for getting back on your feet quickly. If pain isn't managed well, it can also lead to stress, anxiety, and even pain that sticks around for a long time, sometimes linked to feelings of sadness or worry.

Currently, doctors often give strong painkillers called opioids and anti-inflammatory medicines to help with pain after surgery. While these can help, they don't always completely get rid of the pain, and opioids can have some serious side effects, including the risk of becoming dependent on them. Because of this, medical experts are increasingly looking for a better way to manage pain, often by using a combination of different pain relief methods. This approach is called 'multimodal analgesia', and it aims to give better pain relief while reducing unwanted side effects.

This study is investigating one such method called an Erector Spinae Plane (ESP) block. This is a special injection that numbs certain nerves in your back. It's a newer technique that has shown promise in helping with pain after spine surgery. We want to find out if using an ESP block as part of this combined pain relief approach can significantly reduce the amount of opioids needed after neck surgery and ultimately help patients recover more quickly and comfortably.

Key takeaways

This study explores a new injection (ESP block) for pain after neck surgery.
It aims to reduce the need for strong opioid painkillers.
Could lead to a quicker and more comfortable recovery.
Compares the ESP block to a dummy injection (placebo).

Who may be eligible?

This study is looking for adult patients between 18 and 80 years old. You might be able to join if you are having specific neck surgery (called posterior cervical decompression and instrumented fusion) in a face-down position. This surgery is for a condition where your spinal cord in your neck is being squeezed.

However, there are some reasons why you wouldn't be able to take part. For example, if you are allergic to local anaesthetic medications (like those used to numb you at the dentist) or if you are pregnant. You also can't join if you have certain other neck problems, such as a broken neck, tumours in your spine, or if your surgery is for the very top two bones in your neck (C1 and C2).

Finally, if your general health condition is considered very poor (classified as ASA IV by your doctor) or if you are unable to give your full permission to be part of the study, you would also not be able to participate.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you between 18 and 80 years old?
Are you having specific neck surgery for a pinched spinal cord (posterior cervical decompression and instrumented fusion)?
Are you NOT pregnant?
Are you NOT allergic to local anaesthetic medicines?
Do you NOT have a broken neck, spine tumours, or surgery on your very top neck bones (C1/C2)?

Answer every question to see your result.

What does participation involve?

If you decide to take part in this study, you will be randomly assigned to receive either the Erector Spinae (ESP) block with a real numbing medicine (lidocaine/bupivacaine) or an ESP block with a dummy substance (a placebo). This injection will be given around the time of your surgery. Researchers will then carefully monitor your pain levels and the amount of pain medication you need after your operation. They will also look at how quickly you recover and get back to your normal activities. The study will involve assessments both shortly after your surgery and potentially for a longer period to see the lasting effects.

Potential risks and benefits

Taking part in this study may offer a potential benefit of better pain control after your neck surgery and a reduced need for strong opioid painkillers, which could lead to a faster recovery. However, as with any medical procedure, there are potential risks associated with the ESP block, such as bruising, infection, or temporary nerve irritation at the injection site. The study team will explain these risks in detail. It's important to remember that you are free to withdraw from the study at any time, for any reason, without it affecting your usual medical care.

Locations (1)

Toronto Western Hospital?UHN
Verified postcode
Toronto, Canada· Recruiting

Common questions

What is an Erector Spinae (ESP) block?

It's an injection that uses numbing medicine close to certain nerves in your back to help reduce pain after surgery.

Why is this study comparing it to a 'placebo'?

Using a placebo (a dummy injection) helps researchers accurately figure out if the ESP block itself is truly making a difference in pain relief, rather than other factors.

What kind of pain is this study looking at?

The study focuses on pain experienced after surgery, specifically following certain neck operations.

Will I still get pain medication if I'm in the study?

Yes, standard pain management will still be provided. The study is looking at whether the ESP block can reduce the need for strong painkillers like opioids.

How long will I be involved in the study?

The study will involve assessments shortly after your surgery and may continue to monitor your recovery for a longer period, which the team will explain.

How to find out more

Michael Dinsmore, MD

michael.dinsmore@uhn.ca 416 603 5800 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.