{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:18:57Z","timestamp":1787750337020,"version":"build-2784847793"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"Abstract<\/jats:title>\n \n Background and Aims:<\/jats:title>\n Lumbar erector spinae plane block (LESPB) is a promising technique for providing analgesia during hip surgery; however, its efficacy in femur shaft fracture surgery has not been well studied. Furthermore, patient-controlled LESPB has not been compared with patient-controlled epidural analgesia (PCEA).<\/jats:p>\n <\/jats:sec>\n \n Material and Methods:<\/jats:title>\n \n Eighty patients aged 18\u201365 years undergoing unilateral femur fracture surgery were randomly divided to receive either ultrasound-guided patient-controlled LESPB (Group A;\n n<\/jats:italic>\n = 40) or PCEA (Group B;\n n<\/jats:italic>\n = 40) preoperatively, and a catheter was placed. Thereafter, 3 mL of 0.5% hyperbaric bupivacaine with 10 \u03bcg of fentanyl was administered via a subarachnoid block. We compared the cumulative numeric rating scale (NRS) score at 24 h. The secondary objectives included the total local anesthetic (LA) boluses consumed, rescue analgesia required, and patient satisfaction over 24 h in each group.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n NRS at 2 and 4 h was significantly higher in Group A (\n P<\/jats:italic>\n = 0.023 and 0.015, respectively); however, the cumulative NRS at 24 h was comparable (\n P<\/jats:italic>\n = 0.380). The mean (SD) paracetamol requirement [0.22 (0.42) vs. 0.12 (0.33) g;\n P<\/jats:italic>\n = 0.245], tramadol consumption [2.50 (11.04) vs. 1.25 (7.91);\n P<\/jats:italic>\n = 0.569], and time to first rescue analgesia [0.78 (0.67) vs. 1.00 (1.26) h;\n P<\/jats:italic>\n = 1.00] were comparable. The median (interquartile range) LA boluses were comparable between the groups [3 (2\u20134) vs. 3 (2\u20133);\n P<\/jats:italic>\n = 0.243]. The hemodynamic variables and patient satisfaction were similar.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Our results indicate that patient-controlled LESPB is as efficacious as PCEA in patients undergoing femur fracture surgery in terms of cumulative pain scores over 24 h, rescue analgesia requirements, and patient satisfaction. Although there were transiently higher pain scores, its potential relative safety profile compared with epidural analgesia suggests that LESPB is a promising alternative for managing pain in this patient population.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/joacp.joacp_614_25","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T13:05:39Z","timestamp":1782306339000},"page":"417-423","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of patient-controlled lumbar erector spinae plane block with patient-controlled epidural block for postoperative analgesia in patients undergoing surgery for fracture femur"],"prefix":"10.4103","volume":"42","author":[{"given":"Suman","family":"Saini","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, VMMC and SJH Hospital, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.A.","family":"Manu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, VMMC and SJH Hospital, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anju","family":"Gupta","sequence":"additional","affiliation":[{"name":"Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"R1-20260626","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/S0304-3959(02)00458-X","article-title":"The impact of post-operative pain on outcomes following hip fracture","volume":"103","author":"Morrison","year":"2003","journal-title":"Pain"},{"key":"R2-20260626","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1345\/aph.1Q041","article-title":"Influence of intravenous opioid dose on postoperative ileus","volume":"45","author":"Barletta","year":"2011","journal-title":"Ann Pharmacother"},{"key":"R3-20260626","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1213\/ANE.0000000000002489","article-title":"Peripheral nerve blocks for hip fractures: A Cochrane review","volume":"126","author":"Guay","year":"2018","journal-title":"Anesth Analg"},{"key":"R4-20260626","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1097\/00000542-200506000-00020","article-title":"Effect of postoperative epidural analgesia on rehabilitation and pain after hip fracture surgery: A randomised, double-blind, placebo-controlled trial","volume":"102","author":"Foss","year":"2005","journal-title":"Anesthesiology"},{"key":"R5-20260626","doi-asserted-by":"crossref","first-page":"149","DOI":"10.4103\/1658-354X.168806","article-title":"Incidence of lower limb motor weakness in patients receiving post-operative epidural analgesia and associated factors: An observational study","volume":"10","author":"Ahmed","year":"2016","journal-title":"Saudi J Anaesth"},{"key":"R6-20260626","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1097\/AAP.0000000000000451","article-title":"The erector spinae plane block: A novel analgesic technique in thoracic neuropathic pain","volume":"41","author":"Forero","year":"2016","journal-title":"Reg Anesth Pain Med"},{"key":"R7-20260626","doi-asserted-by":"crossref","first-page":"121","DOI":"10.2147\/LRA.S233274","article-title":"Anesthetic techniques: Focus on lumbar erector spinae plane block","volume":"13","author":"Tulgar","year":"2020","journal-title":"Local Reg Anesth"},{"key":"R8-20260626","first-page":"11","article-title":"Randomized controlled study to compare the analgesic efficacy of continuous epidural block with continuous fascia iliaca compartment block for femur surgery done under subarachnoid block","volume":"1","author":"Lingaraj","year":"2015","journal-title":"Univ J Surg Spec"},{"key":"R9-20260626","doi-asserted-by":"crossref","first-page":"825","DOI":"10.4103\/aer.AER_142_18","article-title":"Comparison of ultrasound guided lumbar erector spinae plane block and transmuscular quadratus lumborum block for post-operative analgesia in hip and proximal femur surgery: A prospective randomized feasibility study","volume":"12","author":"Tulgar","year":"2018","journal-title":"Anaesth Essays Res"},{"key":"R10-20260626","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.jclinane.2017.11.006","article-title":"Ultrasound-guided erector spinae plane block at L-4 transverse process level provides effective postoperative analgesia for total hip arthroplasty","volume":"44","author":"Tulgar","year":"2018","journal-title":"J Clin Anesth"},{"key":"R11-20260626","doi-asserted-by":"crossref","first-page":"477","DOI":"10.5152\/TJAR.2021.130","article-title":"Lumbar erector spinae plane block at L3 level for managing postoperative pain in patients undergoing surgery for proximal femur fractures","volume":"49","author":"Diwan","year":"2021","journal-title":"Turk J Anaesthesiol Reanim"},{"key":"R12-20260626","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s42077-021-00167-1","article-title":"Ultrasound-guided lumbar ESP block for post-operative analgesia as an alternative mode of analgesia in hip arthroplasty with multiple systemic issues: A case report","volume":"13","author":"Mujahid","year":"2021","journal-title":"Ain-Shams J Anesthesiol"},{"key":"R13-20260626","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.artd.2021.03.016","article-title":"Continuous lumbar plexus block vs continuous lumbar erector spinae plane block for postoperative pain control after revision total hip arthroplasty","volume":"9","author":"Chen","year":"2021","journal-title":"Arthroplast Today"},{"key":"R14-20260626","first-page":"12","article-title":"Continuous erector spinae plane block at lumbar level for relief of severe pain due to hip fracture: Case series","volume":"49","author":"Tovar-Guti\u00e9rrez","year":"2021","journal-title":"Colombian J Anesth"}],"container-title":["Journal of Anaesthesiology Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.joacp_614_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T12:25:49Z","timestamp":1787747149000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.joacp_614_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/joacp.joacp_614_25","relation":{},"ISSN":["0970-9185","2231-2730"],"issn-type":[{"value":"0970-9185","type":"print"},{"value":"2231-2730","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"assertion":[{"value":"2025-10-05","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-22","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}