Efficacy of an Ultrasound-Guided Erector Spinae Plane Block for Postoperative Analgesia Management After Video-Assisted Thoracic Surgery: A Prospective Randomized Study

Çiftçi, Bahadır; Ekinci, Mine; Çelik, Erkan; Tukac, İsmail Cem; Bayrak, Yusuf; Atalay, Yunus Oktay

doi:10.1053/j.jvca.2019.04.026

Cited by 115 publications

(119 citation statements)

References 19 publications

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“…All RCTs [5][6][7][17][18][19][20][21][22][23][24][25] reported data on intravenous opioid consumption 24 h after surgery . Pooled analysis showed that ultrasound-guided ESPB was associated with a reduction of opioid 24h after surgery (-2.18, 95% CI -2.76 to -1.61; P<.00001; Fig2).…”

Section: Primary Outcomesmentioning

confidence: 99%

Ultrasound-guided Erector Spinae Plane Block for postoperative analgesia: A Meta-Analysis of Randomized Controlled Trials

Huang

Liu

2020

Preprint

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Background Ultrasound-guided Erector Spinae Plane Block (ESPB) has been increasingly applied in patients for postoperative analgesia. Its safety and effectiveness remain uncertain. This meta-analysis aimed to determine the clinical safety and efficacy of ultrasound-guided ESPB in adults undergoing general anesthesia (GA) surgeries. Methods A systematic databases search was conducted in PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) comparing ESPB with control or placebo. Primary outcome was iv. opioid consumption 24 h after surgery. Standardized mean differences (SMDs) or risk ratios (RRs) with 95% confidence intervals (CIs) were calculated with a random-effects model.Results A total of 11 RCTs consisting of 540 patients were included. Ultrasound -guided ESPB showed a reduction of iv. opioid consumption 24 h after surgery (SMD=-2.15; 95% confidence interval (CI) -2.76 to -1.5,p<0.00001), pain scores at 1st hour (SMD=-0.97;95% CI -1.84 to -0.1,p=0.03) and pain scores at 6th hour (SMD=-0.64,95% CI -1.05 to -0.23,p=0.002), Also, it lessened the number of patients who required postoperative analgesia (RR=0.41,95% CI 0.25 to 0.66,p=0,0002) and time to first rescue analgesia (SMD=4.56,95% CI 1.89 to 7.22, p=0.0008). Differences were not significant with the pain score at 12th hour,24th hour and postoperative nausea and vomiting (PONV). Conclusions Ultrasound-guided ESPB provides postoperative analgesic efficacy in adults undergoing GA surgeries with no increase in PONV.

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Section: Primary Outcomesmentioning

confidence: 99%

Ultrasound-guided Erector Spinae Plane Block for postoperative analgesia: A Meta-Analysis of Randomized Controlled Trials

Huang

Liu

2020

Preprint

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“…All RCTs [5][6][7][17][18][19][20][21][22][23][24][25] reported data on intravenous opioid consumption 24 h after surgery. Pooled analysis showed that ultrasound-guided ESPB was associated with a reduction of opioid 24 h after surgery (− 2.18, 95% CI − 2.76 to − 1.61; P < .00001; Fig.…”

Section: Primary Outcomesmentioning

confidence: 99%

Ultrasound-guided erector spinae plane block for postoperative analgesia: a meta-analysis of randomized controlled trials

Huang

Liu

2020

BMC Anesthesiol

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Background: Ultrasound-guided Erector Spinae Plane Block (ESPB) has been increasingly applied in patients for postoperative analgesia. Its effectiveness remain uncertain. This meta-analysis aimed to determine the clinical efficacy of ultrasound-guided ESPB in adults undergoing general anesthesia (GA) surgeries. Methods: A systematic databases search was conducted in PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) comparing ESPB with control or placebo. Primary outcome was iv. opioid consumption 24 h after surgery. Standardized mean differences (SMDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated with a random-effects model. Results: A total of 12 RCTs consisting of 590 patients were included. Ultrasound-guided ESPB showed a reduction of intravenous opioid consumption 24 h after surgery (SMD = − 2.18; 95% confidence interval (CI)-2.76 to − 1.61,p < 0.00001). Considerable heterogeneity was observed (87%). It further reduced the number of patients who required postoperative analgesia (RR = 0.41,95% CI 0.25 to 0.66,p = 0,0002) and prolonged time to first rescue analgesia (SMD = 4.56,95% CI 1.89 to 7.22, p = 0.0008). Conclusions: Ultrasound-guided ESPB provides effective postoperative analgesic in adults undergoing GA surgeries.

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“…Dexamethasone was added to prolong the duration of the block. ESP has since been used to relieve acute post-operative pain in the neck, shoulder, thorax, abdomen, and lower extremities with a variety of vertebral level injection points [10][11][12][13][14][15][16]. Ueshima et al reported two cases in which T4 ESP block relieved tension headache [9].…”

Section: Discussionmentioning

confidence: 99%

T4 Erector Spinae Plane Block Relieves Postdural Puncture Headache: A Case Report

Haan¹,

Chrisman²,

Lee³

et al. 2019

Cureus

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Postdural puncture headache (PDPH) is a common complication of neuraxial anesthesia. The gold standard treatment for PDPH is an epidural blood patch (EBP). However, the risks of EBP, and patient willingness to undergo another attempted neuraxial procedure, can prevent patients from receiving this treatment. The erector spinae plane (ESP) block has been used in the treatment of acute postoperative and chronic pain secondary to many indications at many vertebral levels, and a prior case series describes two patients in which ESP block relieved tension headache. In our case report, we describe a novel use of the ESP block at the fourth thoracic vertebral level to relieve PDPH in a super morbidly obese patient with two prior inadvertent dural punctures.

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Efficacy of an Ultrasound-Guided Erector Spinae Plane Block for Postoperative Analgesia Management After Video-Assisted Thoracic Surgery: A Prospective Randomized Study

Cited by 115 publications

References 19 publications

Ultrasound-guided Erector Spinae Plane Block for postoperative analgesia: A Meta-Analysis of Randomized Controlled Trials

Ultrasound-guided Erector Spinae Plane Block for postoperative analgesia: A Meta-Analysis of Randomized Controlled Trials

Ultrasound-guided erector spinae plane block for postoperative analgesia: a meta-analysis of randomized controlled trials

T4 Erector Spinae Plane Block Relieves Postdural Puncture Headache: A Case Report

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