Intertransverse Process Block Versus Erector Spinae Plane Block for Pain Relief in Lumbar Spine Surgery

The goal of this clinical trial is to learn whether two types of ultrasound-guided nerve block, the intertransverse process block and the erector spinae plane block, reduce pain and the need for opioid pain medicines during and after lumbar spine surgery in adults. It also compares the two blocks with each other. The main questions it aims to answer are: Do patients who receive either nerve block need less morphine in the first 24 hours after surgery than patients who receive only local anesthetic injected at the skin incision? Is there a difference between the two nerve blocks in pain scores, the amount of opioid medicine needed during and after surgery, the time until patients first ask for pain medicine, and side effects? Researchers will compare three groups: an erector spinae plane block group, an intertransverse process block group, and a control group that receives local anesthetic infiltration at the incision site. Participants will: Be randomly assigned to one of the three groups before surgery Receive the nerve block on both sides of the spine with ropivacaine before general anesthesia (block groups), or local anesthetic infiltration along the planned incision after induction of anesthesia (control group) Undergo general anesthesia and lumbar spine surgery following the same standard protocol Use a patient-controlled analgesia pump that delivers morphine on demand for 24 hours after surgery Rate their pain at rest and during movement at set times over the first 24 hours, and be monitored for side effects such as nausea and vomiting