Evaluation of ultrasound-guided erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy: A prospective, randomized, controlled clinical trial

Tulgar, Serkan; Kapaklı, Mahmut Sertan; Şentürk, Özgür; Selvi, Onur; Şerifsoy, Talat Ercan; Özer, Zeliha

doi:10.1016/j.jclinane.2018.06.019

Cited by 175 publications

(161 citation statements)

References 21 publications

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“…Followed by first description by Forero et al [1] in 2016, it has been demonstrated successfully to provide analgesia in thoracic and thoracoabdominal surgeries [3,4] However, the use of ultrasound-guided ESPB remained controversial. Recently, several randomized controlled trials (RCTs) [5][6][7] on this topic have been published, but the determine conclusions cannot be established owing to the modest sample size of these RCTs. We therefore conducted a metaanalysis to examine the efficacy of ultrasound-guided ESPB among adults undergoing general anesthesia (GA) surgery.…”

Section: Introductionmentioning

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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Section: Introductionmentioning

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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“…Regional blocks do not only reduce the use of other analgesics such as opoid, but also prevent their side effects. Studies have been conducted on the efficiency of transversus abdominis plane block (TAP) and ultrasound-guided oblique subcostal transversus abdominis plane block (OS-TAP) for laparoscopic cholecystectomy; [3] however, both blocks have the ability to affect the cutaneous fibers and are therefore more effective on somatic pain. Ortiz et al revealed that TAP block had no significant analgesic activity for this purpose.…”

Section: Discussionmentioning

confidence: 99%

“…As a result of local anesthetic injection into the interfascial space between the transverse process of the vertebrae and the erector spinae muscle, ESPB is performed with the spreading of local anesthesia into multiple paravertebral spaces. [3] We wanted to report the ESPB in pediatric patients. We performed pre-incisionally in laparoscopic cholecystectomy operations for cholelithiasis as a case series study.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Ultrasound-Guided Bilateral Erector Spinae Plane Block for Pediatric Laparoscopic Cholecystectomy: Case Series

Karaca

Pınar

2019

Agri

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ÖzetAmeliyat sonrası opioid uygulaması uyku hali ve solunum sıkıntısı, bulantı ve kusma gibi çeşitli yan etkilere neden olabilir. Multimodal analjezinin bir parçası olarak opioid olmayan ilaçlar, akut cerrahi sonrası ağrının tedavisinde giderek artan ölçüde öne sürülmektedir. Bölgesel bir anestezi tekniği olan Erector spinae plan bloğu (ESPB) hem visseral hem de somatik sinir liflerini bloke eder. Pediatrik cerrahi olgularda çok az uygulaması olan laparoskopik kolesistekomide postoperatif ağrı için bir ESPB vaka serisi sunduk. Laparoskopik kolesistektomi yapılan dört hastaya ultrason eşliğinde bilateral ESPB yapıldı. Anestezi indüksiyonundan sonra, insizyon öncesi dönemde her iki taraftaki fasyalar arasındaki alanına% 0.25 bupivakain enjekte edildi. (toplam anestezi: 2.5 mg/kg) Ameliyat sonrası ağrı kontolü, her sekiz saatte bir 10 mg / kg'lık parasetamol ile planlandı. NRS (sayısal puanlama ölçeği) ağrı skorları, anestezi sonrası bakım ünitesinde (PACU) 1, 2, 4, 8, 12 ve 24. saatlerde üç puanın altındaydı. Kurtarma analjeziklerine (1 mg/kg tramadol) ihtiyaç olmadı. Bu yüzden, uyuşukluk, bulantı ve kusma gibi komplikasyonlar olmadı. Blokla ilişkili herhangi bir komplikasyonla karşılaşılmadı. Multimodal analjezi rejiminin bir parçası olan ESPB'un iki taraflı uygulanması, pediatrik laparoskopik kolesistektomi için postoperatif ilk 24 saatte etkili analjezi sağlamaktadır.Anahtar sözcükler: Erector spina blok; laparoskopik kolesistektomi; pediatri; postoperatif ağrı; ultrason. SummaryPostoperative opioid administration can cause various side effects, such as drowsiness, respiratory distress, postoperative nausea, and vomiting. The use of non-opioid medications as part of a multimodal analgesia method has been increasingly suggested in the management of acute postsurgical pain. Erector spinae plane block (ESPB), which is a regional anesthesia technique, blocks both visceral and somatic nerve fibers. Though it is infrequently used in young patients, presently described is a series of cases in which ESPB was successfully used in the performance of pediatric laparoscopic cholecystectomy. Ultrasound-guided bilateral ESPB was performed on 4 patients who underwent a laparoscopic cholecystectomy. An injection of 0.25% bupivacaine was administered into the interfascial area on each side in the pre-incisional period after the anesthesia induction (total anesthetic: 2.5 mg/kg). Postoperative pain control was planned at 10 mg/kg intravenous paracetamol every 8 hours. Numeric rating scale pain scores were less than 3 points in the post-anesthetic care unit, and at 1, 2, 4, 8, 12, and 24 hours. No rescue analgesic (1 mg/kg tramadol) was needed. None of the typical complications, such as drowsiness or nausea, were observed and no block-related complications were recorded. Bilateral ESPB that is a part of multimodal analgesia regimen can provide effective analgesia for pediatric laparoscopic cholecystectomy patients in the first 24 hours postoperatively.

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“…When performed between T7-T9 levels, it has been reported to effectively attenuate postoperative pain after different types of abdominal surgeries. [6] Recently, Tulgar et al [7] evaluated the effect of US-ESP for postoperative analgesia in laparoscopic cholecystectomy. Authors reported that US-ESP block significantly reduced pain scores of patients when compared to no-intervention group.…”

Section: Discussionmentioning

confidence: 99%

Erector Spinae Plane Block for anesthesia of open ventral hernia repair in severe Ankylosing Spondylitis

Altıparmak¹

2019

Agri

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ÖzetAnkilozan spondilit, havayolu ve aksiyel iskelet tutulumu nedeniyle anestezistler açısından zorlu bir hastalıktır. Ciddi ankilozan spondilit yakınması olan 55 yaşındaki bir erkek hasta Anesteziyoloji kliniğine başvurdu. Orta hat açık ventral herni onarımı planlanmıştı. Ameliyatın tam anestezisi için 4 mcg kg-1 saat-1dexmedetomidine sedasyonu ile birlikte T8 seviyesinden bilateral ultrason rehberlikli erektor spina alan (ESP) bloğu yapmaya karar verdik. ESP bloğunu 25 ml %0.25 bupivakain ile yaptık ve aynı işlemi karşı tarafta tekrar ettik. Yirmibeş dakika sonra cilt insizyonu başladı. Operasyon boyunca ek bir anestezik veya analjezik ajan uygulamaya gerek duymadık. ESP bloğu, enjeksiyon seviyesine göre spinal sinirlerde ventral rami ve komünikan ramiyi etkileyerek, farklı dermatomlarda analjezi sağlar. T7-T9 seviyeleri arasından uygulandığında, farklı tipte ameliyatlardan sonra etkili şekilde postoperatif ağrıyı azalttığı bildirilmiştir. Anahtar sözcükler: Anestezi; ankilozan spondilit; erektor spina alan bloğu; ultrason; ventral herni tamiri. SummaryAnkylosing spondylitis is a challenging disease for anesthesiologist due its airway and axial skeleton involvement. A 55 years old male patient suffering from severe ankylosing spondylitis, admitted to Anesthesiology Clinic. He was planned to receive a midline open ventral hernia repair. We decided to perform bilateral ultrasound-guided erector spinae plane (ESP) block at the level of T8 with 0.4 mcg kg-1 hour-1 dexmedetomidine sedation for complete anesthesia of the surgery. We performed ESP block with 25 mL of 0.25% bupivacaine and repeated the same procedure at the contralateral side. Twenty minutes later, the skin incision was started. We didn't need to apply an additive anesthetic or analgesic drug throughout the surgery. ESP block provides analgesia for different dermatomes by effecting ventral rami and rami communicantes of spinal nerves depending on the level of injection site. When performed between T7-T9 levels, it has been reported to effectively attenuate postoperative pain after different types of surgeries.

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Evaluation of ultrasound-guided erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy: A prospective, randomized, controlled clinical trial

Cited by 175 publications

References 21 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

Efficacy of Ultrasound-Guided Bilateral Erector Spinae Plane Block for Pediatric Laparoscopic Cholecystectomy: Case Series

Erector Spinae Plane Block for anesthesia of open ventral hernia repair in severe Ankylosing Spondylitis

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