Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO

Erector spinae plane (ESP) block is an interfascial blockade, first described by Forero in 2016. The erector spinae muscle (ESM) is a complex formed by the spinalis, longissimus thoracis, and iliocostalis muscles that run vertically in the back. The ESP block is performed by depositing the local anesthetic (LA) in the fascial plane, deeper than the ESM at the tip of the transverse process of the vertebra and LA is distributed in the cranio-caudal fascial plane one dermatome a median of each 3.4 ml of injected volume. 

After obtaining institutional ethical committee clearance, a comparative study will be carried in Rajarajeshwari Medical college and Hospital in Department of Anaesthesia.

The purpose, the procedure and the risks involved with the study will be explained to the patient and an informed consent will be taken. 

All the patients will be reviewed and explained about the procedure.

Patients will be kept nil by oral for 6 hours and will be given T.Pantoprazole 40mg T. Alpralozolam.

On arrival of the patient to the operation theatre, monitors will be connected and base line respiratory rate, pulse rate, non-invasive blood pressure, SPO2 and ECG recorded. Intravenous line of 18G shall be secured and intravenous fluids will be started as per requirement.

Patient in supine position with adequate preoxygenation and premedication with Inj Midazolam 0.01mg/kg and Inj Glycopyrolate 0.2mg will be induced with Inj Fentanyl 1-2mcg/kg, Inj Propofol 2mg/kg and Inj. Vecuronium 0.1mg/kg.

After obtaining adequate muscle relaxation, laryngoscopy will be done and intubated with endotracheal tube. Bilateral airway entry is confirmed and secured appropriately.

Patient is changed to prone position and hemodynamic parameters will be monitored throughout the procedure at regular intervals.

At the end of surgery, under strict aseptic conditions, counting above from L4 vertebrae from the tuffiers line , L3 vertebrae will be identified. A curvilinear USG probe will be placed across the L2 spine and probe will be moved to identify L2 lateral process.

20 ml of 0.25% levobupivacaine is injected below the fascia of erector spinae level using 23G Quincke needle by out of plane technique. Before this 2-3 ml of NS will be injected to make out the spread. In the other group, local wound site infiltration is done using 20 ml of 0.25% levobupivacaine. 

The patient is changed to supine position and extubation will be done after a reversal of residual neuromuscular block with neostigmine (0.05 mg/kg) and glycopyrrolate (0.01 mg/kg) at the end of the surgery. Patients will be transferred to post anesthesia care unit to monitor hemodynamic parameters, postoperative pain, sedation, nausea and vomiting at 0,1,2,4,6,8,12,16,20,24hrs. Patients will be evaluated pain postoperatively for the duration of analgesia and pain will be assessed using a standard 10 cm linear VAS.

Pain assessment will be done 20 minutes after extubation which will be considered as zero time.

Total duration of analgesia will be taken from zero time till the first rescue analgesic requirement.

When VAS score is more than or equal to 4, Inj.Paracetamol 1g will be given as rescue analgesia. Total number of doses of Inj Paracetamol 1g given in 24 hours will be noted.

Patients will be left out of the study in case of block failures