This prospective, randomized controlled trial aims to compare the analgesic efficacy of lumbar paravertebral block (L-PVB) and lumbar erector spinae plane block (L-ESPB) in elderly patients undergoing lumbar spine surgery. Effective postoperative pain management in this population is essential due to increased susceptibility to opioid-related adverse effects.
Participants aged 65 years and older will be randomly assigned to receive either bilateral L-PVB or bilateral L-ESPB in addition to standardized general anesthesia. The primary objective is to evaluate differences in postoperative opioid consumption within the first 48 hours after surgery. Secondary outcomes include pain intensity, intraoperative opioid use, time to mobilization, length of hospital stay, and incidence of opioid-related adverse events.
ge ≥65 years
Scheduled for elective lumbar spine surgery
American Society of Anesthesiologists (ASA) physical status I-III
Ability to assess pain using the Numeric Rating Scale (NRS)
Refusal to participate
Chronic opioid therapy
Coagulation disorders
Use of anticoagulant therapy contraindicating regional anesthesia