Post-Hoc Cost-Utility Analysis of Ultrasound-Guided Erector Spinae Plane (ESP) Block Versus Total Intravenous Anesthesia (TIVA) in Posterior Scoliosis Correction Surgery: Evidence From the Egyptian EQ-5D-5L Value Set

Posterior scoliosis correction surgery is associated with sever postoperative pain that necessitate high perioperative opioid doses to alleviate pain . Regional anesthesia techniques such as ultrasound-guided erector spinae plane (ESP) block have emerged as promising strategies for improving postoperative analgesia and reducing opioid consumption.

This secondary analysis evaluates the cost-utility of ESP block compared with total intravenous anesthesia (TIVA) alone in patients scheduled for posterior scoliosis correction surgery. The analysis assesses postoperative quality of life using the EQ-5D-5L instrument value sets from Egyptian population alongside healthcare costs within the early postoperative period.

The study aims to determine whether ESP block provides improved patient outcomes and represents a cost-effective strategy for perioperative pain management in scoliosis surgery

Study Overview

• Status: Completed
• Conditions: Scoliosis; Spine Deformity

Detailed Description

Posterior scoliosis correction surgery is a major orthopedic procedure that involves extensive surgical exposure and is frequently associated with significant postoperative pain. Effective perioperative analgesia is essential to improve patient comfort, facilitate early recovery, and reduce the risk of opioid-related adverse effects.

Ultrasound-guided erector spinae plane (ESP) block is a relatively recent regional anesthesia technique that has shown promising results in improving postoperative analgesia across several surgical procedures. By providing effective thoracic and paraspinal analgesia, ESP block may reduce intraoperative anesthetic requirements and postoperative opioid consumption.

In addition to clinical benefits, evaluating the economic impact of analgesic strategies is increasingly important, particularly in healthcare systems with limited resources. Economic evaluations such as cost-utility analysis allow healthcare decision makers to assess whether new interventions provide sufficient value relative to their costs.

This study aims to evaluate the cost-utility of using ultrasound-guided ESP block with total intravenous anesthesia compared with total intravenous anesthesia (TIVA) alone in patients undergoing posterior scoliosis correction surgery. Health-related quality of life outcomes were assessed using the EQ-5D-5L instrument, and costs were calculated from a healthcare provider perspective during the early postoperative period (8 hours postoperatively )

The findings of this study may provide important evidence regarding the clinical and economic value of ESP block as part of multimodal analgesia strategies in major spine surgery.

((Artificial intelligence-assisted tools were used to generate preliminary drafts of certain descriptive sections. All outputs were critically reviewed, revised, and approved by the study investigators.))

• Study Type: Observational
• Enrollment (Actual): 44

Contacts and Locations

Study Locations

• Egypt
  • Katameya Road
    • Cairo, Katameya Road, Egypt
      • National Bank Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Patients aged 12-25 years diagnosed with scoliosis and scheduled for posterior spinal fixation surgery were included in the study. All participants were classified as ASA physical status I-III and underwent surgery under general anesthesia in the operating rooms .

Description

Inclusion Criteria:

• Patients aged 12-25 years,
• scheduled for posterior spinal fixation for scoliosis correction.
• ASA physical status I-III,

Exclusion Criteria:

• ASA status > III,
• refusal to participate,
• multiple congenital anomalies,
• hypersensitivity or contraindication to study medications,
• and body weight < 40 kg.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
ESP Block Group Group; Patients undergoing posterior scoliosis correction surgery who received ultrasound-guided erector spinae plane (ESP) block in addition to total intravenous anesthesia (TIVA) as part of multimodal perioperative analgesia. The ESP block was performed under ultrasound guidance prior to surgical incision to provide thoracic paraspinal analgesia
TIVA Control Group; Patients undergoing posterior scoliosis correction surgery who received total intravenous anesthesia (TIVA) without erector spinae plane block. Standard perioperative analgesia and anesthetic management were provided according to institutional protocol

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
economic evaluation (cost utility analysis )of anesthesia (ESP block) compared with (TIVA) alone and the resulting consumption of health resources in patients scheduled for scoliosis correction from a healthcare payer pers	To implement an economic evaluation (cost utility analysis) in addition to the evaluation of clinical effects in order to make rational decisions regarding the acceptance of new mode of anesthesia (ESP block) compared with total intravenous anesthesia (TIVA) alone and the resulting consumption of health resources in patients scheduled for scoliosis correction from a healthcare payer perspective.	2 months

Collaborators and Investigators

• Sponsor: National Bank Hospital
• Investigators: Principal Investigator: basma mohamed, master, National bank hospital ,Cairo, Egypt

Study record dates

Study Major Dates

• Study Start (Actual): October 15, 2025
• Primary Completion (Actual): January 15, 2026
• Study Completion (Actual): February 28, 2026

Study Registration Dates

• First Submitted: March 10, 2026
• First Submitted That Met QC Criteria: March 10, 2026
• First Posted (Actual): March 13, 2026

Study Record Updates

• Last Update Posted (Actual): March 16, 2026
• Last Update Submitted That Met QC Criteria: March 12, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: anesthesia; postoperative pain; erector spinae plan block; cost utility analysis; erector spinae plan block ,regional anesthesia ,postoperative pain ,cost utility analysis , EQ-5D-5L
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Bone Diseases; Musculoskeletal Diseases; Postoperative Complications; Pathologic Processes; Spinal Diseases; Spinal Curvatures; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain, Postoperative; Scoliosis
• Other Study ID Numbers: NBH-ANES-PECON-0326-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: individual participant data (IPD) will not be publicly available. Data will be stored securely at the study institution and may be made available upon reasonable request and with institutional approval.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No