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News
A new randomized trial finds that using deep neuromuscular blockade (NMB) during lumbar spine surgery nearly halves the risk of chronic postsurgical pain at 3 months compared to moderate NMB. Patients in the deep NMB group also used fewer opioids, needed less rescue pain relief, and reported better recovery quality. The findings suggest that reducing early surgical muscle trauma may be key to preventing long-term pain.
A randomized clinical trial out of China found that patients who received deep neuromuscular blockade (NMB) during posterior lumbar interbody fusion surgery had significantly lower rates of chronic postsurgical pain (CPSP) at 3 months compared to those who received moderate NMB — 19.1% vs. 34.8%. The study, published in Anesthesia & Analgesia, enrolled 178 adults and maintained both NMB levels using continuous rocuronium infusion throughout surgery.
Beyond pain incidence, patients in the deep NMB group fared better across multiple recovery metrics — using fewer opioids, requiring less rescue analgesia, and reporting higher quality-of-recovery scores. Surgeons also reported greater satisfaction. The one trade-off: extubation took about 3.7 minutes longer in the deep NMB group.
Chronic postsurgical pain is a major driver of long-term opioid use and reduced quality of life. This trial suggests that a relatively straightforward intraoperative adjustment — going deeper on neuromuscular blockade — could meaningfully reduce that risk, offering spine surgeons and anesthesiologists a practical, evidence-backed tool to improve patient outcomes.
