Background and Aims: Acute pain management in drug addicts is a critical yet understudied topic.
Drug addicts have a decreased pain threshold, impairing anaesthetic pain control. This study aimed
to evaluate the postoperative quality of recovery in addicts and non-addicts after receiving erector
spinae plane block (ESPB) with general anaesthesia. Methods: Sixty males, aged 18‑60 years,
with an American Society of Anesthesiologists physical status I/II, scheduled for elective lumbar
decompression surgery, were divided into two equal groups. Group A included 30 addicts and
group N included 30 non-addicts. Both groups received bilateral ultrasound‑guided ESPB with 20 mL
bupivacaine (0.25%) before induction of general anaesthesia. The primary outcome was comparison
of the 24‑hour postoperative quality of recovery (QoR‑15) score. The secondary outcomes were time
to first analgesic requirement, postoperative pain scores, morphine consumption, and adverse events.
Results: The QoR‑15 score was higher in group N (median = 128.5, interquartile range = 107‑136)
than in group A (118 [99‑130]), indicating a better recovery in group N. The visual analogue scale
pain score was lower in group N than in group A, especially in the first 12 hours postoperatively.
Time to first analgesic request was significantly longer in group N than in group A (mean ± standard
deviation: 8.67 ± 2.74 and 5.53 ± 1.64 hours, respectively, P =0.001), Morphine consumption was
significantly higher in group A than in group N (9.62 ± 3.2 and 7.08 ± 2.57 mg, respectively, P =0.041).
Conclusion: Drug addicts experienced decreased analgesic efficacy of ESPB compared to nonaddicts, with comparable postoperative QoR‑15 score following lumbar decompression surgery. |
