<p>Erector spinae plane block for postoperative analgesia in patients undergoing total abdominal hysterectomy: a randomized controlled study original study</p>

Abstract

Background: Abdominal hysterectomy is associated with marked postoperative pain and morbidity, but effective postoperative analgesia provides early recovery and ambulation. Aim: We intended to assess the efficacy of bilateral erector spinae plane block (ESPB) on postoperative analgesia in females undergoing abdominal hysterectomy under general anesthesia. Settings and Design: The design was a prospective, randomized, controlled, single-blind clinical study. Patients and Methods: Sixty patients with American Society of Anesthesiologists (ASA) physical status classes Ι to ΙΙΙ were scheduled for elective abdominal hysterectomy under general anesthesia, patients were randomly allocated into two equal groups. ESPB patients received ultrasound-guided ESPB at T9 vertebrae level with 20 ml bupivacaine 0.5%. Control group patients did not receive a block. Total fentanyl consumption in the first 24 h and visual analogue scale (VAS) score for pain were evaluated postoperatively. Unpaired Student’s t-tests, chi-square tests, and Z tests were used to compare groups. Results: No significant differences were recorded between the groups regarding age, weight, ASA physical status, or surgery duration, Total fentanyl consumption in the first 24 h was significantly higher in the control group than the ESPB group ( P =0.003; 485±20.39 mcg vs 445±67.49 mcg, respectively), VAS for pain was significantly higher in the control group for the first 12 h postoperatively. Conclusions: Bilateral ESPB provided effective postoperative analgesia and markedly decreased postoperative fentanyl consumption in patients undergoing an abdominal hysterectomy.

<p>Analgesic Efficacy of Erector Spinae Plane Block Compared with Intrathecal Morphine After Elective Cesarean Section: A Prospective Randomized Controlled Study</p>

“…In a study by Tulgar et al, 22 the analgesic effect of ESPB extended for 17, 13, and 16 hrs in three patients undergoing multiple abdominal procedures. In a recent study by Hamed et al, 24 the analgesic effect of ESPB extended for 12 hrs in patients undergoing total abdominal hysterectomy.…”

“…18 Further publications described its use for abdominal surgeries such as ventral hernia repair, 19 abdominoplasty, 20 bariatric surgeries, 21 laparoscopic abdominal surgeries, 22 cesarean section 8,23 and total abdominal hysterectomy. 24 To assess the efficacy of ESPB in patients undergoing ventral hernia repair, Chin et al 19 performed the block at T7 TP in a cadaveric model and evaluated the degree of injectate distribution using a computed tomography scan. They reported that the injectate was distributed cranially to the upper thoracic levels and caudally to the L2-L3 transverse processes.…”

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

“…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).…”

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

“…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.…”