Effect of Deep Versus Moderate Neuromuscular Block on Chronic Postsurgical Pain After Lumbar Spine Surgery: A Randomized Clinical Trial
Primary result · CPSP incidenceResult — go to the resultRelative risk 0.6 95% CI 0.3–0.9Authors' conclusion
Compared to MNMB, DNMB significantly reduced the 3-month incidence of CPSP and decreased opioid consumption in patients undergoing spinal surgery. These clinical benefits were associated with reduced acute muscle injury, as reflected by lower early injury biomarkers and better preservation of long-term paraspinal muscle structure.
Study context
- Population
- Participants scheduled for posterior lumbar interbody fusionrandomized, 178 included in the modified intention-to-treat analysis
- Participants
- 180 participants
- Comparison
- Deep neuromuscular blockade (DNMB) group vs moderate neuromuscular blockade (MNMB) group
- DNMBn = 89
- MNMBn = 89reference
- Primary endpoint
- Chronic postsurgical pain (CPSP) incidence
- Follow-up
- 3 months
Methodological detailsmodified intention-to-treat analysis
- Modified intention-to-treat analysis
Primary result
As reported in the abstract
Relative risk
0.6
95% CI 0.3–0.9
P = 0.018
Events by treatment group
DNMB vs MNMB
RR 0.6 (95% CI 0.3–0.9); P = 0.018
Secondary outcomes
| Outcome | DNMB | MNMB | RR (95% CI) | P value | |
|---|---|---|---|---|---|
| Incidence of CPSP · 6 months | 14.6% | 19.1% | 0.8 (0.4–1.5) | P = 0.423 | |
| 0.512Relative risk (log scale) |
| Outcome | P value |
|---|---|
| Postoperative pain scoresLower in the DNMB group | P < 0.05 |
| Opioid consumptionReduced in the DNMB group | P < 0.001 |
| Surgeons' satisfaction scoresHigher in the DNMB group | P < 0.001 |
| Serum concentrations of CK, MYO, and LDH · postoperative day 1Lower in the DNMB group | all P < .001 |
| CSA and FI of paraspinal muscles on MRI · 6 months | all P < .001 |
- Cross-sectional area (CSA) and fat infiltration (FI) of paraspinal muscles on magnetic resonance imaging (MRI): better preservation of CSA and less progression of FI in the DNMB group
Original publication
Effect of Deep Versus Moderate Neuromuscular Block on Chronic Postsurgical Pain After Lumbar Spine Surgery: A Randomized Clinical Trial. Anesth Analg. Published 7 October 2026. doi:10.
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