scholarly journals Erector Spinae Block for Analgesia : A Safe and Novel Technique with Diverse Applications

2019 ◽  
Vol 2 (1) ◽  
pp. 102-104
Author(s):  
Bigen Man Shakya ◽  
Ninadini Shrestha ◽  
Binita Acharya ◽  
Anil Shrestha ◽  
Renu Gurung ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Postoperative Pain ◽  
Pain Treatment ◽  
Postoperative Pain Management ◽  
Erector Spinae ◽  
Anesthetic Technique ◽  
Contrast Study ◽  
Chronic Pain Management ◽  
Postoperative Pain Treatment

Erector Spinae Block is a paraspinal musculofascial plane block where we inject local anesthetics superficial to the tip of the transverse processes and deep to the erector spinae muscle .It works at the origin of spinal nerves based on cadaveric and contrast study. It is effective and safe regional anesthetic technique. It has a wide variety of applications ranging from acute postoperative pain treatment to chronic pain management. In this series, we report a series of two cases, which include postoperative pain management in Partial Nephrectomy and chronic pain management in Post Herpetic Neuralgia. Keywords: Analgesia; erector spinae block; regional.

Pain assessment and post-operative pain management in orthopedic patients

2017 ◽  
Vol 16 (1) ◽  
pp. 181-181
Author(s):  
W. Schmelling ◽  
J.N. Poulsen ◽  
L. Christrup ◽  
P. Gazerani
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Postoperative Pain ◽  
Potential Risk ◽  
Health Care Professionals ◽  
Sleep Disturbances ◽  
Pain Treatment ◽  
Early Mobilization ◽  
Postoperative Pain Management ◽  
Orthopedic Patients

Abstract Aims A fast-track based surgical treatment reduces morbidity and hospital stay by providing early mobilization. Sufficient postoperative pain management is mandatory for early mobilization and optimal utilization of rehabilitation measures. Insufficient postoperative pain management is however a widespread problem. Lack of knowledge about pain and pain treatment among health care professionals and general community has been considered as a major potential contributor in insufficient pain management. It has been suggested that severe postoperative pain might imply a potential risk of developing chronic pain. The purpose of this study was to examine this problem in acute and elective surgical patients in department of orthopedic surgery at Bispebjerg Hospital in order to identify obstacles and possibilities for future improvement. Methods Questionnaires were developed and distributed to patients consisted of 10 acute admitted and 10 elective orthopedic patients. The patients’ pain scores were recorded with a 0–10 NRS scale. The scores were obtained for current pain in rest, current pain in activity, and the highest and lowest pain intensity for the last 24 hours. Data were handled using descriptive statistics. Results The goal for sufficient pain treatment was patients with pain score at ≤ 3 NRS at rest and ≤ 5 in activity. For pain at rest 45% of the patients were within the goal range and 55% for the current pain in activity. For the mildest pain experienced in the last 24 h, 75% and for the worst pain experienced 30% of the patients reached the goal. Conclusions Corresponding to similar studies, half of the patients received a sufficient pain treatment at the time of examination. The consequences for insufficient pain management would be reduced effect of the physiotherapy, reduced ability to handle every day activity, sleep disturbances, and potential risk of developing chronic pain.

Postoperative Thoracic Pain Treatment: Serratus Anterior or Erector Spinae Plane Block?

2020 ◽  
Author(s):  
Ayşe Ülgey ◽  
Sibel Seçkin Pehlivan ◽  
Ömer Faruk Demir
Keyword(s):  
Pain Management ◽  
Thoracic Surgery ◽  
Pain Treatment ◽  
Postoperative Pain Management ◽  
Erector Spinae ◽  
Morphine Consumption ◽  
Serratus Anterior ◽  
Thoracic Pain ◽  
Erector Spinae Plane Block ◽  
Pca Method

Abstract Background Thoracic surgery is one of the most painful surgeries. Effective analgesia is important in postoperative pain management. In this study, we aimed to compare the two new fascial block techniques. Methods A total of 107 patients who underwent thoracic surgery between October 2018 and November 2019 were retrospectively evaluated. The study included 59 patients in the serratus anterior plane block (SAPB) group and 48 patients in the erector spinae plane block (ESPB) group. Both groups were administered 30 mL of 0.25% bupivacaine and their morphine consumption was evaluated by a patient-controlled analgesia (PCA) method during the 2nd, 6th, 12th, 24th, and 48th postoperative hours. Pain was measured with the visual analog scale (VAS). Intraoperative mean arterial pressure (MAP) and heart rate (HR) were recorded. Results During the first 24 hours, VAS values were significantly lower in the ESPB group (p < 0.05). Moreover, morphine consumption was significantly lower in the ESPB group in the 24th and 48th hours (p < 0.05). Intraoperative remifentanil consumption was also significantly lower in the ESPB group (p < 0.05). Intraoperative MAP in the ESPB group was found to be significantly lower after the 4th hour. HR was similar in both groups. Conclusion ESPB was more effective compared with SAPB in postoperative thoracic pain management.

Postoperative Pain Management

2018 ◽  
Author(s):  
Q. Cece Chen ◽  
Shengping Zou
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Pain Treatment ◽  
Postoperative Pain Management ◽  
Cost Of Care ◽  
Patient Comfort ◽  
Treatment Modalities ◽  
Surgical Patient ◽  
Coordinated Care ◽  
Unrealistic Expectations

Postoperative pain management is an important aspect of caring for a surgical patient as inadequate pain control can be associated with increased morbidity and mortality. Failure to effectively control postoperative pain is often due to poor communication and poorly coordinated care between the care teams, poor communication with the patient, insufficient education, unrealistic expectations, fear of complications from the pain regimen, inaccurate pain assessment, and limited effective pain treatment modalities. An effective pain management can therefore lead to improved patient comfort, satisfaction, earlier ambulation, faster recovery time, decreased hospital stay and cost of care, and reduced postoperative complications.

Erector spinae plane block in chronic pain management: a scoping review

2021 ◽  
pp. 030089162098593
Author(s):  
Dmitriy Viderman ◽  
Antonio Sarria-Santamera
Keyword(s):  
Chronic Pain ◽  
Clinical Practice ◽  
Pain Management ◽  
Scoping Review ◽  
Case Series ◽  
Erector Spinae ◽  
Chronic Pain Management ◽  
Efficacy And Safety ◽  
Erector Spinae Plane Block

Chronic pain is reaching epidemic levels. Chronic pain represents a significant burden for patients, healthcare systems, and society, given its impact on quality of life, increased disability, and risk of hospitalization and mortality. Unmet needs of chronic pain management are also significant as only a small percentage of patients respond to medical (drug) therapy. Erector spinae plane block (ESPB) was rapidly adapted in clinical practice and numerous cases have been published assessing its effectiveness, but no systematic review of evidence on ESPB in chronic pain management is available. The purpose of this scoping review is to perform a comprehensive overview of existing evidence on ESPB in chronic pain management. We analyzed cases and case series reporting 43 patients. ESPB was performed in patients with severe pain and in all cases resulted in some degree of pain relief. However, because there was heterogeneity in mechanisms and underlying causes of chronic pain, preprocedural analgesic therapy, and pain assessment in reporting the cases, with the information currently available (case reports) we cannot make a definitive conclusion regarding efficacy and safety of ESPB in chronic pain management. Lack of homogeneity was present in medication use before the procedure, indicating a significant variation in how patients with chronic pain are managed. Variation in clinical practice can indicate the need to improve the quality of care to alleviate the chronic pain burden. Randomized controlled clinical trials are warranted to establish efficacy and safety of ESPB in chronic pain management.

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.

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