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 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.

Epipleural surgical block and ultrasound-guided erector spinae plane block for analgesia in VATS

2021 ◽  
Keyword(s):  
Postoperative Pain ◽  
Thoracic Surgery ◽  
Postoperative Analgesia ◽  
Local Anesthetic ◽  
Erector Spinae ◽  
Ultrasound Guided ◽  
Additional Method ◽  
Video Tutorial ◽  
Erector Spinae Plane Block ◽  
Severe Postoperative Pain

Thoracic surgery is still associated with severe postoperative pain. In this video tutorial, we present 2 techniques that could be used as an additional method in a multimodal postoperative analgesia strategy for video-assisted thoracic surgery. We present the combination of an epipleural surgical infiltration of a local anesthetic with an ultrasound-guided erector spinae plane block.

scholarly journals A Randomised Controlled Study to Evaluate Efficacy of the Landmark Guided Erector Spinae Plane Block for Postoperative Pain in Percutaneous Nephrolithotomy Surgeries in Kolhapur District in Western Maharashtra

2021 ◽  
Vol 8 (20) ◽  
pp. 1559-1564
Author(s):  
Rashmee Vijay Chavan ◽  
Archita Rajaram Patil ◽  
Anupama Deepak Sahasrabudhe ◽  
Aarati Bhaskar Jadhav ◽  
Prithiv Rishardhan Prabhakaran
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
General Anaesthesia ◽  
Percutaneous Nephrolithotomy ◽  
Erector Spinae ◽  
Control Group ◽  
Study Group ◽  
Vas Score ◽  
Erector Spinae Plane Block ◽  
Post Operative Pain

BACKGROUND Post-operative pain and discomfort is a common side effect of percutaneous nephrolithotomy (PCNL) surgery. The study intended to evaluate the efficacy of landmark guided erector spinae plane block (ESPB) in early post-operative pain relief following (PCNL) surgery. METHODS In this randomised prospective, single blind, interventional study, 70 patients aged 20 - 60 years of ASA grade I and II, scheduled for elective percutaneous nephrolithotomy (PCNL) surgery under general anaesthesia were included. Patients were randomly allotted into two groups of 35 each. Group 1 was the control group and received parenteral analgesia according to institutional protocol for postoperative pain relief. Group 2 was the study group and received landmark guided erector spinae plane block (ESPB) with 20 cc of 0.25 % bupivacaine for postoperative pain relief. Post-operatively patients were monitored for pain and Visual Analogue Scale (VAS) score was noted at 2nd, 4th and 6th hr and was maintained below 4 by providing them with additional analgesics if required. Time and doses of analgesics required were recorded. RESULTS All the statistical analysis was done using R-Studio 1.2.5001 software. MannWhitney-U test was used for quantitative variables of pain score. Proportion test was used for qualitative demographic data and for post-operative analgesics requirement. Both the groups were comparable on demographic variables. The average VAS score at 2nd and 4th hr was significantly lower in the study group than in the control group (P < 0.05). The VAS score at 6th hr was comparable in both the groups. The analgesic requirement was significantly lower in study group as compared to the control group. CONCLUSIONS The landmark guided ESPB is an effective and simple method to alleviate immediate postoperative pain in PCNL surgeries under general anaesthesia. KEYWORDS Erector Spinae Plane Block, Percutaneous Nephrolithotomy Surgery, Postoperative Pain

scholarly journals Ultrasound-Guided Erector Spinae Plane Block Versus Thoracic Paravertebral Block on Postoperative Analgesia After Laparoscopic Nephroureterectomy: Study Protocol of A Randomized, Double Blinded, Non-Inferiority Design Trial

2020 ◽  
Author(s):  
Zhen-Zhen Xu ◽  
Xue Li ◽  
Zhen Zhang ◽  
Zheng-Ye Liu ◽  
Lin-Lin Song ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Opioid Consumption ◽  
Paravertebral Block ◽  
Erector Spinae ◽  
Ultrasound Guided ◽  
Thoracic Paravertebral Block ◽  
Erector Spinae Plane Block ◽  
Urological Surgery ◽  
Double Blinded ◽  
Laparoscopic Nephroureterectomy

Abstract Introduction: Erector spinae plane block (ESPB) is a novel inter-fascial plane block, which is applied more and more in postoperative pain control, especially in chest surgery. Attention is increasingly paid to its premium analgesia in urological surgery. Therefore, we aimed to explore whether ESPB would have similar analgesia compared with thoracic paravertebral block (TPVB) in laparoscopic nephroureterectomy surgery.Methods and analysis: This prospective, randomized, double-blinded, non-inferiority trial will enroll 166 patients undergoing laparoscopic nephroureterectomy. Participants will be randomly assigned 1:1 into receiving ESPB or TPVB before surgery. Both ultrasound-guided ESPB or TPVB will be performed with an injection of 0.375% ropivacaine 0.4ml/kg before anesthesia induction. Standardized patients controlled intravenous analgesia (PCIA) will be applied for each patient. The primary endpoint is the joint of cumulative 24h opioid (sufentanil) consumption and average pain score via numeric rating scale (NRS) at 24th h after surgery. Secondary endpoints include rescued analgesic demand, cumulative opioid consumption and pain NRS scores at different preset timepoint within 48h after surgery. Other predefined outcomes include clinical features of blockage, quality of recovery, subjective sleep quality, time to ambulation and flatus, and adverse events, as well as length of stay in hospital and anesthesia cost. Discussion: Previous studies investigating the analgesic efficacy of ESPB only concentrated on a single endpoint for postoperative pain evaluation, while studies focusing on the direct comparation between ESPB and TPVB in urological surgery is still lacking. Our study is the first trial in non-inferiority design of comparing ESPB and TPVB in patient undergoing laparoscopic nephroureterectomy surgery, and the primary outcome is the joint endpoint of opioid consumption and pain NRS score.Trial registration: Chinese Clinical Trial Registry, ChiCTR 2000031916. Registered on 14 April 2020. http://www.chictr.org.cn/showproj.aspx?proj=50782

scholarly journals SHOULD THE ERECTOR SPINAE PLANE BLOCK BE APPLIED IN THE PAIN MANAGEMENT OF PERCUTANEOUS NEPHROLITHOTOMY?

2021 ◽  
Author(s):  
Şeyma Ünal ◽  
Semih Başkan ◽  
Betül GÜVEN AYTAÇ ◽  
İsmail Aytaç
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Percutaneous Nephrolithotomy ◽  
Length Of Hospital Stay ◽  
Postoperative Pain Management ◽  
Erector Spinae ◽  
Controlled Study ◽  
Control Group ◽  
Rescue Analgesia ◽  
Erector Spinae Plane Block

The Aim: This prospective, randomised controlled study aimed to investigate the efficacy and respiratory effects of postoperative pain management with erector spinae plane block (ESPB) in patients undergoing percutaneous nephrolithotomy surgery. Methods: A total of 60 ASA I-II patients aged 18–65 years, scheduled to undergo percutaneous nephrolithotomy (PCNL) were included. Patients were randomized either to the ESPB or control group. Ultrasound-guided ESPB with 15mL 0.5% bupivacaine at the T11 level was performed preoperatively using the in-plane technique in the ESP group. In both groups, 1gr of intravenous paracetamol was administered intraoperatively. Postoperative pain and agitation was evaluated using VAS, Dynamic VAS at 0, 6 and 24 hours and the Riker sedation-agitation scale at 0th Hours after surgery. Peak expiratory flow rate(PEFR) and SPO2 were measured in preoperative examination and at the 0th, 6th, 24th hours postoperatively. In the postoperative period, intravenous tramadol (100mg) was administered as a rescue analgesic when VAS ≥ 4. Time and number of the rescue analgesias, mobilization time and length of hospital stay were also recorded and analyzed. Results: A significantly lower VAS and DVAS were observed at 0th, 6th, 24th hours in the ESPB group (p < 0.05 for each timepoint). Also number of and time to rescue analgesia decreased in the ESPB group (p< 0.05 and 0.01 respectively). Postoperative/preoperative PEFR ratio was lower and there were more agitated patients in control group (p<0.05). Conclusion: ESPB may have additional clinical advantages while providing effective analgesia in patients who underwent PCNL comparing to intravenous analgesia.

Sign in / Sign up

Export Citation Format

Share Document