scholarly journals A Randomized Trial to Compare Serratus Anterior Plane Block and Erector Spinae Plane Block for Pain Management Following Thoracoscopic Surgery

Pain Medicine ◽  
2020 ◽  
Vol 21 (6) ◽  
pp. 1248-1254
Author(s):  
Mürsel Ekinci ◽  
Bahadir Ciftci ◽  
Birzat Emre Gölboyu ◽  
Yavuz Demiraran ◽  
Yusuf Bayrak ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Thoracoscopic Surgery ◽  
Opioid Consumption ◽  
Erector Spinae ◽  
Serratus Anterior ◽  
Erector Spinae Plane Block ◽  
Significant Difference ◽  
Vas Scores ◽  
Anterior Plane ◽  
Effective Analgesia

Abstract Objective Comparison of ultrasound (US)-guided erector spinae plane block (ESPB) and serratus anterior plane block (SAPB) in video-assisted thoracic surgery (VATS) patients. The primary outcome was to compare perioperative and postoperative (48 hours) opioid consumption. Methods A total of 60 patients were randomized into two groups (N = 30): an ESPB group and an SAPB group. All the patients received intravenous patient-controlled postoperative analgesia and ibuprofen 400 mg intravenously every eight hours. Visual analog scale (VAS) scores, opioid consumption, and adverse events were recorded. Results Intraoperative and postoperative opioid consumption at 0–8, 8–16, and 16–24 hours and rescue analgesic use were significantly lower in the ESPB group (P < 0.05). Static/dynamic VAS scores were significantly lower in the ESPB group (P < 0.05). There was no significant difference between static VAS scores at the fourth hour. There were no differences between adverse effects. Block procedure time and one-time puncture success were similar between groups (P  > 0.05 each). Conclusion US-guided ESPB may provide better pain control than SAPB after VATS. Question Even though there are studies about analgesia management after VATS, clinicians want to perform the technique that is both less invasive and more effective. Findings This randomized trial showed that US-guided ESPB provides effective analgesia compared with SAPB. Meaning Performing single-injection ESPB reduces VAS scores and opioid consumption compared with SAPB.

A randomized trial of erector spinae plane block for analgesia after video-assisted thoracoscopic surgery

2019 ◽  
Author(s):  
Yang Jin ◽  
Xuemei Jiang ◽  
Meng Sun ◽  
Xin Lv ◽  
Zongmei Wen
Keyword(s):  
Postoperative Pain ◽  
Thoracoscopic Surgery ◽  
Controlled Trial ◽  
Opioid Consumption ◽  
Erector Spinae ◽  
Secondary Outcome ◽  
Video Assisted ◽  
Erector Spinae Plane Block ◽  
The Impact ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background: Erector spinae plane block (ESPB) is a novel local nerve block technique. However, evidence regarding the impact of ESPB on postoperative pain management after video-assisted thoracoscopic surgery (VATS) is lacking. This randomized controlled trial aimed to evaluate the effect of erector spinae plane block on postoperative analgesia and intra-operative opioid consumption for video-assisted thoracoscopic surgery patients. Methods: We randomly allocated 91 participants to block with 30ml ropivacaine 0.375% (n=45), or no block without placebo or sham procedure (n=46). We analyzed results from 41 participants in each group ultimately. The primary outcome was postoperative NRS pain score. The secondary outcome was intra-operative sufentanil consumption. Postoperative QoR-40 scores and postoperative complications were also recorded. Results: Erector spinae plane block reduced the median (IQR) pain scores during postoperative 0-1h, 1-6h, 6-12h and 12-24h: 3 (3-5) vs. 6 (5-7), p<0.0001; 5 (3-5) vs. 6 (5-7), p<0.0001; 4 (3-5) vs. 6 (5-7), p<0.0001 and 4 (3-5) vs. 5 (5-7), p<0.0001, respectively. Block also reduced the mean (SD) intra-operative total sufentanil consumption and per hour, per kilogram sufentanil consumption, as well as increased the median (IQR) global QoR-40 scores on POD1. Conclusions: Erector spinae plane block can be used to reduce postoperative pain and intra-operative opioid consumption for VATS patients.

scholarly journals Dexmedetomidine as an adjuvant to bupivacaine in ultrasound-guided serratus anterior plane block in patients undergoing video-assisted thoracoscopic surgeries

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Mohammed Abdelsalam Menshawi ◽  
Hany Magdy Fahim
Keyword(s):  
Study Groups ◽  
Ultrasound Guided ◽  
Serratus Anterior ◽  
Hemodynamic Stability ◽  
Video Assisted ◽  
Significant Difference ◽  
Sedation Scores ◽  
Vas Scores ◽  
Group B ◽  
Anterior Plane

Abstract Background The purpose of this study was the assessment of the analgesic and hemodynamic implications of dexmedetomidine used as an additive to bupivacaine in ultrasound-guided serratus anterior plane (SAP) block for patients undergoing video-assisted thoracoscopic surgeries (VATS ) under general anesthesia. Results The hemodynamic stability was maintained perioperatively with no significant difference of MBP and HR recordings between the two study groups (P > 0.05). The time to 1st postoperative analgesic demand was significantly longer in group BD than in group B (P < 0.05). The postoperative total nalbuphine and rescue ketorolac requirements were significantly lower in group BD than in group B (P < 0.05). The VAS scores were significantly lower in group BD at 8th and 12th h postoperatively than in group B, with no significant difference at 0–6 h and 18–24 h postoperatively (P > 0.05). Ramsay sedation scores were significantly higher in the group BD than in group B in the initial 1st h after surgery (P < 0.05) with no significant difference at the subsequent postoperative recordings (P > 0.05). Conclusion Using dexmedetomidine (0.5 μg/kg) as an additive to bupivacaine for SAP block prolongs the duration of postoperative analgesia and reduces the postoperative analgesic requirements in the 1st 24 h after VATS without any significant side effects.

The Effects of Erector Spinae Plane Block on Perioperative Opioid Consumption and Rehabilitation in Video Assisted Thoracic Surgery

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

Abstract Background The present study aimed to observe whether the ultrasound-guided continuous erector spinae plane block (ESPB) has an effect on opioid consumption and postoperative rehabilitation in patients who undergo video-assisted thoracic surgery (VATS).Methods In this prospective study, 120 patients aged 20–70 yrs, undergoing elective VATS, were randomly allocated to one of three groups: Group C (General anaesthesia with patient-controlled intravenous analgesia [PCIA]), Group T (General anaesthesia with patient-controlled epidural analgesia [PCEA]), or Group E (General anaesthesia with continuous ESPB and PCIA). The perioperative opioid consumption; VAS scores; preoperative and postoperative QoR-15 score; and postoperative opioid-related adverse events were all assessed.Results The intraoperative sufentanil consumption in group 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 of 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 (PACU), at postoperative 6h, 12h, and 24h, were significantly lower in group T (P < 0.05). However, the VAS scores in group E were lower than those of group C only at rest at postoperative 6h and 12h (P < 0.05), and were significantly higher than those of group T at all study times (P < 0.05).Conclusion Ultrasound-guided continuous ESPB could significantly reduce perioperative opioid consumption in VATS and improve postoperative rehabilitation. However, these effects were inferior to those provided by TEA.Trial registration The present study was prospectively registered at http://www.chictr.org/cn /(Registration number: ChiCTR1900023050); Registration date: May 8,2019

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.

Erector spinae plane block associated to serratus anterior plane block for awake radical mastectomy in a patient with extreme obesity

2021 ◽  
Vol 87 (6) ◽  
Author(s):  
Domenico P. SANTONASTASO ◽  
Annabella DE CHIARA ◽  
Claude T. BAGAPHOU ◽  
Alessio CITTADINI ◽  
Federica MARSIGLI ◽  
...  
Keyword(s):  
Radical Mastectomy ◽  
Erector Spinae ◽  
Extreme Obesity ◽  
Serratus Anterior ◽  
Erector Spinae Plane Block ◽  
Anterior Plane

scholarly journals Perineural dexmedetomidine added to ropivacaine for ultrasound-guided erector spinae plane block prolongs analgesia duration and reduces postoperative opioid consumption after thoracotomy: a prospective, randomized study

2020 ◽  
Author(s):  
Qiang Wang ◽  
Ruoshan Liu ◽  
Shijing Wei ◽  
Guohua Zhang ◽  
Cheng Ni ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Adverse Effects ◽  
Rating Scale ◽  
Single Injection ◽  
Randomized Study ◽  
Opioid Consumption ◽  
Erector Spinae ◽  
Open Thoracotomy ◽  
Erector Spinae Plane Block ◽  
Significant Difference

Abstract Background: Single-injection erector spinae plane block (ESPB) has been reported to be successfully used for analgesia after open thoracotomy. However, the duration of analgesia is not long enough. Adding dexmedetomidine to local anesthetics is frequently used to prolong the duration of single-injection regional nerve block. This randomized study was designed to assess whether adding dexmedetomidine to ropivacaine for ESPB could effectively prolong the duration of analgesia and reduce opioid consumption after open thoracotomy.Methods: Sixty patients with esophageal cancer were randomized to receive ESPB using 28 mL of 0.5% ropivacaine, with 2 mL of normal saline (group R) or 0.5 µg/kg dexmedetomidine in 2 mL (group RD) administered perineurally. ESPB was performed at the 5th thoracic level under ultrasound guidance. The primary outcome was the duration of analgesia. The secondary outcomes were total postoperative sufentanil consumption, numerical rating scale pain scores, Ramsay sedation scale scores and adverse effects.Results: The duration of analgesia in group RD (505.1±113.9) was longer than that in group R (323.2±75.4) (p<0.001). The total postoperative sufentanil consumption was lower in group RD (23.3±10.0) than in group R (33.8±13.8) (p=0.001). There was no significant difference in the incidence of adverse effects between the two groups.Conclusion: Adding perineural dexmedetomidine to ropivacaine for ESPB seems to be an attractive method for prolonging analgesia with almost no adverse effects in patients with esophageal cancer undergoing curative-intent thoracotomy. Trial registration: ChiCTR1800016583. Registered 10 June 2018, http://www.chictr.org.cn.

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