Distribution of a Solution in the Epidural Space

Capogna, Giorgio

doi:10.1007/978-3-030-45332-9_3

Cited by 1 publication

(1 citation statement)

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“…10 The epidural analgesia is a well-established and highly effective block in which the LA spreads from the epidural space to the spinal cord, nerve roots, and the cerebrospinal fluid. 11 Our results are in line with previous reports on the ESBP in lumbar spine surgery in which the block was compared with various analgesic regimens, such as intravenous opioid analgesia 12 and a mid-transverse process to pleura block. 13 Only one study showed no difference in pain scores between patients who received an ESPB and those who did not, and the authors attributed this result to the small volume of local anesthetic that was injected.…”

Section: Discussionsupporting

confidence: 91%

Erector spinae plane block vs. single shot epidural block for postoperative analgesia in lumbar spine surgery: a randomized controlled trial

Abdelhamid¹,

ElSabbagh²,

Amin³

et al. 2022

Anaesth. pain intensive care

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Background: Epidural block is an effective route for analgesia in spine surgeries. Erector spinae plane block (ESPB) is a field block that showed promising results in various surgeries. We compared both procedures in spine surgery, regarding postoperative pain, the time to first analgesic request, postoperative total morphine consumption, perioperative hemodynamics, and any adverse events. Methodology: Sixty-seven patients were enrolled in this double-blinded randomized controlled study. Patients were allocated into two groups. The epidural group received an ultrasound-guided single-shot epidural block with 20 mL of 0.25% bupivacaine. The ESPB group received an ultrasound-guided bilateral single-shot ESPB with 20 mL of 0.25% bupivacaine for each side. Postoperative pain, the time to first analgesic request, postoperative total morphine consumption, perioperative hemodynamics, and any adverse events were recorded. Results: The time to the first analgesic requirement was longer in the ESPB group (11.5 [9-14] h, vs. 7 [5-8] h, P < 0.001). The mean morphine consumption was lower in the ESPB group (3.88 ± 0.54 vs. 7.12 ± 1.94 mg; P < 0.001). The numeric rating scale was lower in the epidural group. Less patients experienced intraoperative hypotension and tachycardia in ESPB group. Conclusion: ESPB provides longer postoperative analgesia, less opioid consumption, and more intraoperative hemodynamic stability when compared with a single-shot epidural block in lumbar spine surgery. Trial registration: The ethical approval was obtained from the Research Ethics Committee of Cairo University (M D-82-2019), and the trial was registered on www.clinicaltrials.gov with registration number (NCT04320212). https://clinicaltrials.gov/ct2/show/NCT04320212 Abbreviations: ESPB - Erector spinae plane block; LA - Local anesthetics Key words: Erector spinae plane block; Pain, Postoperative; Spine surgery; Analgesia, Epidural; Fascial plane blocks; Neuraxial analgesia Citation: Abdelhamid HS, ElSabbagh HA, Amin SM, Abdelhakim AK. Erector spinae plane block vs. single shot epidural block for postoperative analgesia in lumbar spine surgery: a randomized controlled trial. Anaesth. pain intensive care 2022;26(3):310-317. DOI: 10.35975/apic.v26i3.1897 Received: February 01, 2022; Reviewed: March 13, 2022; Accepted: March 23, 2022

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