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 Efficacy and Safety of Ultrasound-Guided, Bi-Level, Erector Spinae Plane Block With Different Doses of Dexmedetomidine for Patients Undergoing Video-Assisted Thoracic Surgery: A Randomized Controlled Trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiujuan Gao ◽  
Tonghang Zhao ◽  
Guangjun Xu ◽  
Chunguang Ren ◽  
Guoying Liu ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Thoracic Surgery ◽  
Pain Score ◽  
Recovery Time ◽  
Erector Spinae ◽  
Efficacy And Safety ◽  
Ultrasound Guided ◽  
Video Assisted Thoracic Surgery ◽  
Erector Spinae Plane Block ◽  
Different Doses

Background: The anesthetic characteristics of ultrasound-guided bi-level erector spinae plane block (ESPB) plus dexmedetomidine (Dex) remain unclear. We compared the efficacy and safety of ultrasound-guided bi-level ESPB plus different doses of Dex in patients undergoing video-assisted thoracic surgery (VATS).Methods: One-hundred eight patients undergoing VATS were randomized into three groups: R group (n = 38, 15 ml of 0.375% ropivacaine with 0.1 mg/kg dexamethasone), RD1 group (n = 38, 15 ml of 0.375% ropivacaine plus 0.5 μg/kg DEX with 0.1 mg/kg dexamethasone) and RD2 group (n = 38, 15 ml of 0.375% ropivacaine plus 1.0 μg/kg DEX with 0.1 mg/kg dexamethasone). The primary outcome was the pain 12 h after surgery. Secondary outcomes included the Prince Henry Hospital Pain Score; hemodynamics; consumption of sufentanil; anesthetized dermatomal distribution; recovery time; rescue analgesia; satisfaction scores of patients and surgeon; quick recovery index; adverse effects; the prevalence of chronic pain and quality of recovery.Results: The visual analog scale (VAS) and the Prince Henry pain score were significantly lower in both the RD1 and RD2 groups during the first 24 h after surgery (P &lt; 0.05). Both VAS with coughing and the Prince Henry pain score were significantly lower in the RD2 group than in the RD1 group 8–24 h after surgery (P &lt; 0.05). Both heart rate and mean arterial pressure were significantly different from T2 to T6 in the RD1 and RD2 groups (P &lt; 0.05). The receipt of remifentanil, propofol, Dex, and recovery time was significantly reduced in the RD2 group (P &lt; 0.05). The requirement for sufentanil during the 8–72 h after surgery, less rescue medication, and total press times were significantly lower in the RD2 group (P &lt; 0.05). The time to the first dose of rescue ketorolac was significantly longer in the RD2 group (P &lt; 0.05). Further, anal exhaust, removal of chest tubes, and ambulation were significantly shorter in the RD2 group (P &lt; 0.05). The incidence of tachycardia, post-operative nausea and vomiting, and chronic pain was significantly reduced in the RD2 group, while the QoR-40 score was significantly higher in the RD2 group (P &lt; 0.05).Conclusions: Pre-operative bi-level, single-injection ESPB plus 1 μg/kg DEX provided superior pain relief and long-term post-operative recovery for patients undergoing VATS.Clinical Trial Registration:http://www.chictr.org.cn/searchproj.aspx.

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.

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.

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

scholarly journals Use of Complementary and Alternative Medical Services by HMO Members, 1995-1996

2001 ◽  
Vol 7 (2) ◽  
pp. 85-98 ◽  
Author(s):  
Evelyn P. Whitlock
Keyword(s):  
Multivariate Analysis ◽  
Patient Satisfaction ◽  
Health Status ◽  
Service Users ◽  
Improve Patient Satisfaction ◽  
Kaiser Permanente ◽  
Reported Health ◽  
Self Reported Health Status ◽  
Improve Patient ◽  
Complementary And Alternative

We investigated HMO members' use of complementary and alternative medicine (CAM) providers outside the HMO in 1995-1996. A random 2% survey of Kaiser Permanente Northwest members addressed HMO service satisfaction, self-reported health status and behaviors, and HMO utilization. Among respondents, 15.7% (n = 380) used CAM providers (chiropractors, naturopaths, acupuncturists, others) in the prior 12 months, while 35% were ever users. Multivariate analysis found that those more likely to consult CAM providers were females, more educated, and more dissatisfied with the HMO. These results suggest that HMOs may wish to focus efforts to improve patient satisfaction among CAM service users.

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