Effects of ultrasound-guided erector spinae plane block on postoperative analgesia and plasma cytokine levels after uniportal VATS: a prospective randomized controlled trial

Liu, Lin; Ni, Xin-Xin; Zhang, Lingwei; Zhao, Kai; Xie, Haiyang; Zhu, Jiang

doi:10.1007/s00540-020-02848-x

Cited by 30 publications

(36 citation statements)

References 20 publications

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“…Out of the 52 RCTs, 11 were about breast surgeries, 24–26 , 31 , 36 , 38 , 39 , 47 , 48 , 54 , 64 15 were about orthopedic surgeries, 10 , 11 , 21–23 , 27 , 28 , 32 , 33 , 50 , 52 , 53 , 56 , 57 , 60 5 were about thoracoscopic surgeries, 12 , 25 , 34 , 58 , 59 6 were about cholecystectomy, 29 , 30 , 41 , 45 , 63 , 65 6 were about nephrolithotomy, 37 , 44 , 49 , 61 , 62 , 68 2 were about cardiac surgeries, 14 , 42 and 7 were others. 40 , 43 , 46 , 51 , 55 , 66 , 67 The characteristics of enrolled 52 studies were listed in the Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Erector spinae plane block (ESPB), one of novel regional techniques, was described in 2016 by Forero et al 8 and it had been performed for breast surgery, 9 lumbar spine surgery, 10 , 11 thoracoscopic surgery, 12 cholecystectomy, 13 and cardiac surgery. 14 Despite ESPB is widely used in many regions to treat perioperative pain, its benefits are still somewhat controversial.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Single-Shot Erector Spinae Plane Block (ESPB) on Opioid Consumption for Various Surgeries: A Meta-Analysis of Randomized Controlled Trials

Cui¹,

Wang²,

Yang³

et al. 2022

JPR

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Study Objective Pain management plays a pivotal role in enhanced recovery after surgery (ERAS). Erector spinae plane block (ESPB) is widely used in many regions to treat perioperative pain, but its benefits are still somewhat controversial. We, therefore, intent to systematically review the available literature on ESPB, to elucidate its effects on opioid-sparing analgesia, and summarize its potential complications. Design Systematic review of randomized controlled trials (RCTs) with meta-analysis. Setting Postoperative opioid consumption for various surgeries. Patients Patients undergoing various surgeries. Intervention We searched relevant studies in PubMed, EMBASE, Medline, and the Cochrane Library up to May 16, 2021. All prospective and RCTs that compared ESPB and sham block or no block were enrolled. Measurements The primary outcomes were postoperative opioid consumption during the first 24 hours. The secondary outcomes were the requirement of rescue analgesia, time to first rescue analgesic and ESPB-related adverse events. Results We included 52 trials that reported postoperative opioid consumption during the first 24 hours. The results presented that compared to control group (ie, no intervention or a sham block), ESPB reduced the accumulated opioid consumption during the first 24 h after surgery [mean difference (MD) of − 12.83 (95% CI: − 17.29 to − 8.38; p < 0.001) mg; I 2 = 100%]. Besides, ESPB could prolong time to first rescue analgesia after surgery [SMD = 5.31; 95% CI 4.01–6.61; p < 0.001; I 2 = 97%]. The number of patients who received rescue analgesia after surgery in the ESPB group was less than that in the control group (OR 0.13; 95% CI 0.09, 0.21; p < 0.001; I 2 = 54%), and the incidence of PONV was lower in the ESPB group (OR 0.51; 95% CI 0.43, 0.62; p < 0.001; I 2 = 19%). Conclusion ESPB is an effective technique on pain management with few complications.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effect of Single-Shot Erector Spinae Plane Block (ESPB) on Opioid Consumption for Various Surgeries: A Meta-Analysis of Randomized Controlled Trials

Cui¹,

Wang²,

Yang³

et al. 2022

JPR

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“…ESP blocks are increasingly used for thoracic analgesia in VATS since they are relatively easy to execute (even for novices in regional anesthesia) and are performed far from vascular structures in a compressible site, superficial to the bony floor provided by the transverse process, instead of rib cage. These blocks have also shown to reduce intraand postoperative opioid consumption and the level of inflammatory cytokines in the postoperative period (29). The analgesic effect of an ESP block illustrated to be noninferior to that of a PVB, 24 h after VATS surgery.…”

Section: Optimal Postoperative Thoracic Analgesia After Vats Remains An Open Issuementioning

confidence: 99%

Perioperative pain management for thoracic surgery: a narrative review of the literature

Clairoux¹,

Issa²,

Bélanger³

et al. 2023

Curr Chall Thorac Surg

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The objective of this article was to review the evidence regarding multimodal analgesia drugs and regional block techniques in the context of thoracic surgery, with a special focus on video-assisted thoracic surgery (VATS).Background: Despite advances in surgical technique and the increased use of minimally invasive surgery, postoperative pain after thoracic surgery is still significant, especially in the first two postoperative days.Inadequate pain control leads to a reduced rate of pulmonary recovery which can lead to atelectasis, hypoxemia and pneumonia and is significantly linked to an increased incidence of chronic postsurgical pain.However, the optimal analgesic protocol that allows adequate postoperative pain control and facilitates fast recovery of this population has yet to be determined.Methods: An extensive review of articles published between January 1980 and November 2020 using different combinations of search terms that were relevant to the topic was conducted using PubMed search engine. All published full articles randomised controlled trials comparing the analgesic efficacy of a regional block or of a multimodal analgesic drug to a placebo in patients undergoing either thoracotomy or VATS were included in this review.Conclusions: Analgesic protocols in thoracic surgery must take into consideration the surgery that is being performed (VATS or thoracotomy) as well as patient's characteristics. Regional blocks are highly effective at providing good postoperative pain control although their duration is limited. Various non opioid analgesic drugs have been evaluated in order to address the various pain generators that cause postoperative pain after thoracic surgery, although none has become a clinical standard. Using a combined multimodal and regional analgesic protocol could improve postoperative pain control and decrease the use of parenteral opioids and their unwanted side effects. Recommendations on multimodal analgesic protocols are given based on the literature.

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“…17 [25][26][27][28]30,31,33,35,[37][38][39][40][41][42][43][44][45] RCTs reported opioid consumption and 18 [25,26,28,[30][31][32][33][34][35][36][38][39][40][41][42][43][44][45],…”

Section: Efficacy Outcomes (Network Meta-analysis)mentioning

confidence: 99%

“…16 [25,26,[28][29][30][31][32][33][34][35][38][39][40][41][42][43][44] , 17 [25][26][27]29,30,[33][34][35][36][38][39][40][41][42][43][44][45] RCTs reported pain score for each time period during the postoperative 24 hours. The networks for TPVB and Control were greater than the networks for other blocks, followed ESPB and Control.…”

Section: Efficacy Outcomes (Network Meta-analysis)mentioning

confidence: 99%

Regional analgesia techniques for video-assisted thoracic surgery: a frequentist network meta-analysis

Park

et al. 2022

Korean J Anesthesiol

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Effects of ultrasound-guided erector spinae plane block on postoperative analgesia and plasma cytokine levels after uniportal VATS: a prospective randomized controlled trial

Cited by 30 publications

References 20 publications

The Effect of Single-Shot Erector Spinae Plane Block (ESPB) on Opioid Consumption for Various Surgeries: A Meta-Analysis of Randomized Controlled Trials

The Effect of Single-Shot Erector Spinae Plane Block (ESPB) on Opioid Consumption for Various Surgeries: A Meta-Analysis of Randomized Controlled Trials

Perioperative pain management for thoracic surgery: a narrative review of the literature

Regional analgesia techniques for video-assisted thoracic surgery: a frequentist network meta-analysis

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