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Background and Aims This study compared the effects of erector spinae plane (ESP) block administered either preoperatively or postoperatively on postoperative acute pain, opioid consumption, and quality of recovery in patients undergoing spinal surgery.Methods A total of 46 patients aged between 18 and 75 years, classified as ASA I–III, and scheduled for elective lumbar spinal surgery were included in this prospective, randomized, double-blind study. Ethics committee approval was obtained, and the study was registered at ClinicalTrials.gov before patient enrollment. After obtaining verbal and written informed consent, patients were randomized via computer-based allocation. ESP block was performed before surgery in Group 1 and after surgery (prior to awakening) in Group 2. The primary outcome was total opioid consumption. Secondary outcomes included NRS pain scores assessed at 0, 1, 6, 12, 18, and 24 hours postoperatively, and quality of recovery measured by QoR-40 at 24 hours. Additional postoperative analgesia requirements, time to mobilization, time to discharge, and side effects were also recorded.Results There was no significant difference in total opioid consumption between the groups (p>0.05). However, NRS pain scores were significantly lower in Group 2 at 18 and 24 hours (p<0.05). Among the QoR-40 subscales, only the ‘comfort’ score was significantly higher in Group 1 (p<0.05); no differences were observed in other subcategories. There were no significant differences between the groups in terms of additional analgesia requirements, time to first mobilization, discharge timing, or side effects.Conclusions Although total opioid consumption and overall quality of recovery scores were largely similar between the groups (except for the comfort subscale), postoperative ESP block may be more effective in controlling late postoperative pain. Despite potential anatomical disruption following spinal surgery, ESP block remains effective when performed postoperatively. Further studies are needed to explore the mechanism of action of ESP block.