The effect of intraoperative lidocaine administration in a disrupted erector spinae fascial plane on intercostal transcranial motor evoked potentials

Study objective: Erector spinae plane (ESP) blocks have been recently described for postoperative pain manage-ment following spine surgery but their effects on intraoperative neuromonitoring are unknown.Design: Retrospective cohort study.Setting: Pediatric patients at a tertiary care center.Patients: 26 pediatric patients who received bilateral surgically-placed ESP catheters for single-stage posterior spine fusion (PSF) from August 2020 to June 2021.Interventions: Patients in this study did not receive any special interventions as part of this observational retro-spective study. Measurements: This retrospective study investigated the effects of local anesthesia administration through bilateral surgically-placed ESP catheters on intraoperative intercostal transcranial motor evoked potentials (tcMEPs) in the setting of a disrupted erector spinae fascial plane in pediatric patients undergoing single-stage posterior spine fusion.Main results: Of the 26 patients that received bilateral surgically-placed ESP catheters for pediatric posterior spine fusion surgery, none exhibited any changes in intercostal tcMEPs attributable to intraoperative lidocaine administration through the ESP catheters.Conclusions: The administration of a local anesthetic into a disrupted erector spinae fascial plane does not appear to interfere with intraoperative neuromonitoring of posterior spine fusion surgeries.

Automated summary

The study aimed to investigate the effects of local anesthesia administration through ESP catheters on intraoperative intercostal tcMEPs in pediatric patients undergoing posterior spine fusion. The results showed that lidocaine administration through ESP catheters did not cause any changes in intercostal tcMEPs in the 26 patients studied.