scholarly journals Ultrasound-guided bilateral erector spinae plane block in laparoscopic colon cancer surgery

2021 ◽  
Author(s):  
Qijin Li ◽  
Quanchu Li ◽  
Weiping Peng ◽  
Zhenzhen Liu ◽  
Yaohai Mai ◽  
...  
Keyword(s):  
Colon Cancer ◽  
General Anesthesia ◽  
Enhanced Recovery ◽  
Intervention Group ◽  
Oral Intake ◽  
Erector Spinae ◽  
Control Group ◽  
Ultrasound Guided ◽  
Erector Spinae Plane Block ◽  
Laparoscopic Colon

Abstract Background The efficacy of erector spinae plane block (ESPB) for pain control in other surgeries remains an interesting topic of discussion. This study aimed to evaluate the safety and efficacy and quality of recovery of ultrasound-guided bilateral ESPB in laparoscopic surgery for colon cancer. Material and methods In this study 50 patients were included and randomly divided into the intervention group (E group, n = 25) and the control group (C group, n = 25). Patients in the E group received general anesthesia with preoperative bilateral ultrasound-guided ESPB, whereas patients in the C group received general anesthesia with saline injection in the erector spinae plane preoperatively. Data on intraoperative and postoperative anesthetic effects and the effect on enhanced recovery after surgery were recorded and analyzed. Results Rocuronium consumption in the intervention group was 82.80 ± 21.70 mg, which was lower than that in the control group (P < 0.05). Visual analog scale scores at 2, 6, and 24 h after surgery in the intervention group were lower than those in the control group (Fbetween = 34.034, P = 0.000). The time to ambulation, consumption of ketorolac tromethamine, time to oral intake and hospital stay after operation in the intervention group were significantly lower than those in the control group (P < 0.05). The block area at the different baselines was significant (Fbetween = 3.211, P = 0.009). The association between baseline and time was significant (Fbaseline * time = 3.268, P = 0.001). Conclusion This study confirmed that ultrasound-guided ESPB technology is safe and beneficial for patients with colon cancer undergoing laparoscopic colon surgery.

scholarly journals Prospective Study: The Analgesic Efficacy of Ultrasound-Guided Erector Spinae Plane Block versus Serratus Plane Block in Patients Undergoing Modified Radical Mastectomy

2021 ◽  
pp. 9-18
Author(s):  
Martina Farag Wahba Mekhaeil ◽  
Ayman Abd Elmaksod Yousef ◽  
Hesham Mohammed Marof ◽  
Shaimaa Farouk Abdelkader
Keyword(s):  
Radical Mastectomy ◽  
Analgesic Efficacy ◽  
Erector Spinae ◽  
Control Group ◽  
Modified Radical Mastectomy ◽  
Ultrasound Guided ◽  
Serratus Anterior ◽  
Group Iii ◽  
Erector Spinae Plane Block ◽  
Group I

Background: Breast Cancer is the most commonly occurring cancer affecting ‎women undergoing modified radical mastectomy, causing acute pain, and in ‎high percentage of patients it progresses to chronic pain syndromes. The Erector Spinae Plane Block (ESPB) ‎and Serratus Anterior Plane Block (SAPB) are options of regional anesthesia that can produce reliable ‎analgesia. In this study we aimed to evaluate the analgesic efficacy of ‎ultrasound guided ESPB and SAPB in patients underwent modified radical ‎mastectomy operation. Patients and Methods: Patients were randomly classified using computer generated numbers ‎concealed in ‎ sealed opaque envelopes into three equal groups; 30 patients ‎were enrolled in each group. ‎Group I: Control Group (C): Patients received intravenous (IV) systemic analgesia only, Group II: ESPB group: Patients received ‎ipsilateral ultrasound guided ESPB using 20 ml bupivacaine 0.25% at the ‎level of the 4th thoracic segment (T4). and Group III: SPB group: Patients received ipsilateral ‎serratus plane block using 30 ml bupivacaine 0.25% at the level of the 5th rib.‎ Results: In this study, 113 patients were assessed for eligibility, 16 patients ‎did not meet the criteria and 7 patients refused to participate in the study. ‎The remaining 90 patients were randomly allocated into three groups (30 ‎patients in each). All patients (90) were followed-up and analyzed ‎statistically‎. Conclusion: Ultrasound-guided SAPB and ESPB provided effective post-‎operative analgesia in patients undergoing modified radical mastectomy with ‎lower pain scores, less peri operative analgesic consumption and longer ‎duration of analgesia in SAPB.

Clinical benefits of a swallowing intervention for esophageal cancer patients after esophagectomy

2020 ◽  
Author(s):  
Jun Takatsu ◽  
Eiji Higaki ◽  
Takahiro Hosoi ◽  
Masahiro Yoshida ◽  
Masahiko Yamamoto ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Enhanced Recovery ◽  
Intervention Group ◽  
Oral Intake ◽  
Control Group ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Swallowing Function ◽  
Nerve Paralysis ◽  
Postoperative Stay

Summary Dysphagia after esophagectomy is the main cause of a prolonged postoperative stay. The present study investigated the effects of a swallowing intervention led by a speech–language–hearing therapist (SLHT) on postoperative dysphagia. We enrolled 276 consecutive esophageal cancer patients who underwent esophagectomy and cervical esophagogastric anastomosis between July 2015 and December 2018; 109 received standard care (control group) and 167 were treated by a swallowing intervention (intervention group). In the intervention group, swallowing function screening and rehabilitation based on each patient’s dysfunction were led by SLHT. The start of oral intake, length of oral intake rehabilitation, and length of the postoperative stay were compared in the two groups. The patient’s subgroups in the 276 patients were examined to clarify the more effectiveness of the intervention. The start of oral intake was significantly earlier in the intervention group (POD: 11 vs. 8 days; P = 0.009). In the subgroup analysis, the length of the postoperative stay was also significantly shortened by the swallowing intervention in patients without complications (POD: 18 vs. 14 days; P = 0.001) and with recurrent laryngeal nerve paralysis (RLNP) (POD: 30 vs. 21.5 days; P = 0.003). A multivariate regression analysis identified the swallowing intervention as a significant independent factor for the earlier start of oral intake and a shorter postoperative stay in patients without complications and with RLNP. Our proposed swallowing intervention is beneficial for the earlier start of oral intake and discharge after esophagectomy, particularly in patients without complications and with RLNP. This program may contribute to enhanced recovery after surgery.

scholarly journals Bilateral lumbar Ultrasound-guided Erector Spinae Plane Block versus Local Anaesthetic Infiltration for Perioperative Analgesia in Lumbar Spine Surgery: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Alessandro Vergari ◽  
Luciano Frassanito ◽  
Mariangela Muro ◽  
Roberta Nestorini ◽  
Angelo Chierichini ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Opioid Analgesic ◽  
Erector Spinae ◽  
Lumbar Spine Surgery ◽  
Control Group ◽  
Ultrasound Guided ◽  
Local Infiltration ◽  
Erector Spinae Plane Block

Abstract BackgroundLumbar spinal surgery is associated with severe postoperative pain. We examined the analgesic efficacy of bilateral lumbar ultrasound-guided erector spinae plane block (ESPB) with ropivacaine compared with local infiltration of ropivacaine.Methods Twenty-four patients undergoing elective lumbar arthrodesis were randomly divided into two groups. Control group received 0.375 % ropivacaine 40 ml through the wound, and ESPB group received preoperative bilateral ESPB with 0.375 % ropivacaine 40 ml. The primary outcome was postoperative pain intensity at rest using a Numeric Rating Scale (NRS). Secondary outcomes included difference in pain intensity between pre-intervention and defined timepoints, total amount of opioid analgesic requested by the patients at the same timepoints, the incidence of any adverse event, and the length of hospital stay (LOS) after surgery.Results After surgery we detected a NRS value of 1.9 + 1.6 in ESPB group and 6.0 + 1.7 in Control group (p<0.05). In the ESPB group we found a significant decrease (from 6.3 ± 1.6 to 1.9 ± 1.7) of NRS score after surgery compared to pre-surgery values. About the opioid consumption we found a total sufentanil tablets consumption of 17 ± 9 and 10 ± 2 at 48h for Control group and ESPB group, respectively. Concerning LOS all patients in the Control group and 9 of the ESPB group were discharged after 72 hours; 3 patients in the ESPB group left the ward after 48 hours. Conclusion Bilateral ultrasound-guided ESPB offers improved postoperative analgesia compared with local infiltration in patients undergoing lumbar spinal surgery.Trial Registration Number on Clinicaltrial.gov: NCT04123106

scholarly journals Ultrasound-guided single erector spinae plane block versus thoracic paravertebral block for patients undergoing video-assisted thoracoscopic lobectomy: a single center randomized controlled trial

2020 ◽  
Author(s):  
Danxu Ma ◽  
Huilong Ren ◽  
Xueyang Li ◽  
Huili Li ◽  
Jia Jiang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Postoperative Analgesia ◽  
Controlled Trial ◽  
Erector Spinae ◽  
Control Group ◽  
Ultrasound Guided ◽  
Thoracic Paravertebral Block ◽  
Randomized Controlled ◽  
Erector Spinae Plane Block ◽  
Vas Scores

Abstract Background: Whether ultrasound-guided erector spinae plane block (ESPB) can replace thoracic paravertebral block (TPVB) remains unknown. This study aimed to determine the efficacy of ESPB compared with TPVB for postoperative analgesia after video-assisted thoracoscopic lobectomy under general anesthesia. Methods: This prospective randomized controlled trial divided patients into a control group, a TPVB group (0.3 mL/kg, 0.5% ropivacaine), and an ESPB group (0.5 mL/kg, 0.5% ropivacaine). Dermatomes with loss of pinprick sensation, were recorded during 30 min after block administration. Visual analog scale (VAS) scores, total analgesic dose, and complications after surgery were recorded. Results: Whether at rest or during coughing, the VAS scores were lower in ESPB group at 1, 6, 18, 24, and 48 h after surgery compared with the Control group. VAS scores were similar in the ESPB and TPVB groups at 1 h, but were lower in the ESPB group at 6, 18, 24, and 48 h postoperatively. Conclusions: Single ESPB provided superior postoperative analgesia than TPVB, without causing any adverse effect.

scholarly journals The use of ultrasound guided erector spinae plane block to optimize anesthetic regimen and improve patient satisfaction for open thoracic surgery: a randomized controlled clinical study

2019 ◽  
Author(s):  
Qiang Wang ◽  
Shuai Li ◽  
Shijing Wei ◽  
Guo-Hua Zhang ◽  
Yong Li ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
General Anesthesia ◽  
Recovery Time ◽  
Tracheal Extubation ◽  
Erector Spinae ◽  
Ultrasound Guided ◽  
Improve Patient Satisfaction ◽  
Erector Spinae Plane Block ◽  
Extubation Time ◽  
Improve Patient

Abstract Background: The opioid-related side effects exist extensively and have significant adverse effects on patients’ recovery from general anesthesia and patient overall satisfaction after the thoracotomy. Recently, the erector spinae plane block (ESPB) has been reported to be used as a new effective analgesia for thoracic neuropathic pain. This randomized study was designed to assess whether ultrasound guided ESPB could effectively reduce the intraoperative consumption of opioids, improve the quality of recovery, reduce postoperative adverse events and improve patient satisfaction. Methods: Sixty patients undergoing open thoracic surgery were allocated randomly into the following 2 groups: Combined ultrasound guided ESPB and general anesthesia (GA) group (group EG, n = 30), and only GA group (group GA, n = 30). In group EG, before general anesthetic induction, the ultrasound guided ESPB was performed at the level of the T5 transverse process 3 cm from the midline. Then, 25 ml of 0.5% ropivacaine was injected deep to the erector spinae muscle. In both groups, the general anesthesia was inducted with 2 mg/kg of propofol, 0.3 ug/kg of sufentanil, 0.6 mg/kg rocuronium. Then, the general anesthesia was maintained by inhaling 2.5%-3.0% sevoflurane (1.3-1.5 MAC) and intermittent administration of sufentanil and rocuronium. The intraoperative consumption of sufentanil, recovery time, tracheal extubation time, dermatomal levels of sensory blockade by ESPB, pain score at 60 minutes after surgery, consumption of rescue analgesic tramadol, postoperative adverse events and patient satisfaction with anesthetic regimen during 48 hours after the thoracotomy were all recorded. Results: The cutaneous sensory block of ESPB was from T2 to T9. Compared with group GA, the intraoperative sufentanil consumption, pain score, tramadol consumption, incidence of nausea and vomiting were all significantly less in group EG (p < 0.05). In addition, the recovery time and tracheal extubation time were both significantly shorter in group EG compared to group GA (p < 0.001). And the patient satisfaction with anesthetic regimen in group EG was significantly higher compared to group GA (p < 0.001). Conclusions: Ultrasound guided ESPB combined with GA could significantly reduce intraoperative opioids consumption, provide a better recovery and improve patient satisfaction for open thoracotomy.

scholarly journals The effects of erector spinae plane block on perioperative opioid consumption and rehabilitation in video assisted thoracic surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sen Zhang ◽  
Xiaodan Han ◽  
Di Zhou ◽  
Minli Sun ◽  
Jing Cang ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
General Anesthesia ◽  
Opioid Consumption ◽  
Erector Spinae ◽  
Ultrasound Guided ◽  
Postoperative Rehabilitation ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Erector Spinae Plane Block ◽  
Vas Scores

Abstract Background This study aimed to determine whether ultrasound-guided continuous erector spinae plane block (ESPB) had an effect on opioid consumption and postoperative rehabilitation in patients undergoing video-assisted thoracic surgery (VATS). Methods In this prospective study, 120 patients aged 20–70 years who underwent elective VATS were randomly allocated to one of three groups: group C (general anesthesia with patient-controlled intravenous analgesia [PCIA]), group T (general anesthesia with patient-controlled epidural analgesia [PCEA]), or group E (general anesthesia with continuous ESPB and PCIA). Perioperative opioid consumption, visual analog scale (VAS) scores, preoperative and postoperative Quality of Recovery-15 scores, and postoperative opioid-related adverse events were all assessed. Results Intraoperative sufentanil consumption in groups T and E was significantly lower than that in group C (both P < 0.001), and the postoperative sufentanil consumption in group E was also significantly lower than that in group C (P = 0.001). Compared with group C, the VAS scores at rest or during coughing immediately out of the post-anesthesia care unit at 6 h, 12 h, and 24 h postoperatively were significantly lower in group T (P < 0.05). However, the VAS scores at rest at 6 h and 12 h postoperatively in group E were lower than those of group C (P < 0.05), but were significantly higher than those of group T at all study times (P < 0.05). Conclusion Ultrasound-guided continuous ESPB significantly reduced perioperative opioid consumption during VATS and improved postoperative rehabilitation. However, these effects were inferior to those of thoracic epidural anesthesia. Trial registration The present study was prospectively registered at http://www.chictr.org/cn /(registration number: ChiCTR1900023050); registration date: May 82,019.

Ultrasound-guided erector spinae plane block and dexmedetomidine cooperative sedation for non-intubated chest wall surgery

2019 ◽  
Vol 85 (12) ◽  
Author(s):  
Selene Ranocchia ◽  
Paolo Scimia ◽  
Carolina Giordano ◽  
Vinicio Danzi ◽  
Elena Bignami
Keyword(s):  
Chest Wall ◽  
Erector Spinae ◽  
Ultrasound Guided ◽  
Erector Spinae Plane Block
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