Comparison of Postoperative Analgesic Efficacy Using Analgesia Nociception Index Monitoring in Patients Undergoing Elective Lumbar Spine Surgery: A Randomized Parallel-Group Study

What this Trial Is About

Researchers are studying pain management methods for adults undergoing elective lumbar spine surgery. This randomized study compares two approaches: an ultrasound-guided erector spinae plane block (ESPB) and intravenous multimodal analgesia. The goal is to see which method provides better control of postoperative pain using both clinical scores and a monitoring system called the Analgesia Nociception Index (ANI), which measures pain-related responses through heart rate variability. Participants are randomly assigned to one of two groups. One group receives an ultrasound-guided bilateral ESPB with 200 mg of bupivacaine at the thoracolumbar level. The other group receives intravenous multimodal analgesia including paracetamol, morphine, dexamethasone, and ketamine with specified doses and infusion rates. ANI values and clinical pain scores are recorded at multiple time points from immediately after surgery up to 24 hours. During the study, participants will have their pain monitored using ANI at specific intervals along with clinical pain scores, opioid consumption, hemodynamic measurements, and any adverse effects. The primary measure is the ANI from 0 minutes to 24 hours after surgery. Secondary measures include pain scores using the Visual Analog Scale and the incidence of nausea within 24 hours. The study is sponsored by Akdeniz University Hospital and includes adult patients aged 18 to 65 years.

Postoperative Pain Monitoring With ANI in Lumbar Spine Surgery