Postoperative analgesic effectiveness of bilateral erector spinae plane block for adult cardiac surgery:  a randomized controlled trial

Güven, Bülent; ERTÜRK, Tuna; Ersoy, Ayşın

doi:10.32322/jhsm.1013908

Cited by 7 publications

(11 citation statements)

References 25 publications

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“…Finally, we included 16 studies which included 1110 patients for analysis (489 in ESPB and 621 in control), [ Figure 1 ]. [ 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 ] Table 1 summarizes the details of all the studies included in the analysis.…”

Section: Resultsmentioning

confidence: 99%

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Erector Spinae Plane Block for Postoperative Analgesia in Cardiac Surgeries- A Systematic Review and Meta-Analysis

Nair

Saxena

Borkar

et al. 2023

Annals of Cardiac Anaesthesia

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Ultrasound-guided erector spinae plane block (ESPB) has been used in many studies for providing opioid-sparing analgesia after various cardiac surgeries. We performed a systematic review and meta-analysis of randomized controlled trials to assess the efficacy of ESPB in cardiac surgeries. We searched PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar to identify the studies in which ESPB was compared with the control group/sham block in patients undergoing cardiac surgeries. The primary outcomes were postoperative opioid consumption and postoperative pain scores. The secondary outcomes were intraoperative opioid consumption, ventilation time, time to the first mobilization, length of ICU and hospital stay, and adverse events. Out of 607 studies identified, 16 studies (n = 1110 patients) fulfilled inclusion criteria and were used for qualitative and quantitative analysis. Although, 24-hr opioid consumption were comparable in both groups group (MD, −18.74; 95% CI, −46.85 to 9.36, P = 0.16), the 48-hr opioid consumption was significantly less in ESPB group than control ((MD, −11.01; 95% CI, −19.98 to −−2.04, P = 0.02). The pain scores at various time intervals and intraoperative opioid consumption were significantly less in ESPB group. Moreover, duration of ventilation, time to the first mobilization, and length of ICU and hospital were also less in ESPB group (P < 0.00001, P < 0.00001, P < 0.00001, and P < 0.0001, respectively). This systematic review and meta-analysis demonstrated that ESPB provides opioid-sparing perioperative analgesia, facilitates early extubation and mobilization, leads to early discharge from ICU and hospital, and has lesser pruritus when compared to control in patients undergoing cardiac surgeries.

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Section: Resultsmentioning

confidence: 99%

“…Eight studies reported 24-hr morphine consumption[ 14 15 16 17 18 19 20 21 ] and 5 studies[ 22 23 24 25 26 ] reported 48-hr opioid consumption. For 24-hr morphine consumption, there were 232 patients in ESPB group and 240 patients in the control group.…”

Section: Resultsmentioning

confidence: 99%

Erector Spinae Plane Block for Postoperative Analgesia in Cardiac Surgeries- A Systematic Review and Meta-Analysis

Nair

Saxena

Borkar

et al. 2023

Annals of Cardiac Anaesthesia

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“…For this purpose, plane blockers applied to the thoracic wall have been widely accepted in recent years. In addition, these blocks have become an indispensable part of the concept of acceleration of recovery after thoracic surgery (ERATS) due to the potential for thoracic epidural analgesia and less side effects compared to thoracic paravertebral blocks (19)(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Comparison of deep and combined serratus anterior plane block after video-assisted thoracoscopic surgery; a prospective randomized trial

Zengin

Baldemir

Ulger

et al. 2023

Journal of Health Sciences and Medicine

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Aim: Ultrasound-guided plane blocks have been employed frequently in Video-assisted thoracoscopic surgery (VATS). The aim of this study was to evaluate the effect of deep and combined serratus anterior plane block (SAPB) after VATS. Material and Method: The patients, in the age range of 18 to 65 years, with the American Society of Anesthesiologists (ASA) physical status of I-III, and body mass index (BMI) of 18-30 kg/m2, and undergoing lung resection with VATS were included in the study. Patients were informed about the study, and their written consent was obtained. Patients were divided into Deep SAPB (DSAPB) (Group 1) and combined SAPB (CSAPB) (Group 2) groups according to the analgesia protocol. Results: There was no statistically significant difference between the groups in terms of demographic characteristics and surgical features (p > 0.05). When the groups were evaluated in terms of the block performance time, it was found to be statistically significantly longer in the CSAPB group than in the DSAPB group (p < 0.001). When the groups were evaluated in terms of VAS resting scores, the 1st, 2nd, 4th, 8th, and 16th, 24th, and 48th-hour VAS resting results were found to be statistically significantly higher in the DSAPB group than the CSAPB group (p < 0.05). VAS cough scores were statistically significantly higher in the DSAPB group at the 1st, 2nd, 4th, 8th, and 16th, 24th, and 48th-hour (p < 0.05). When the groups were evaluated in terms of the side effects, additional analgesic use, and morphine consumption, they were found to be statistically significantly higher in the DSAPB group than in the CSAPB group (p: 0.026, p: 0.020, p < 0.001, respectively). Conclusion: CSAPB provided effective analgesia after VATS for 48 hours. In addition, morphine consumption and the need for additional analgesics were low in CSAPB. However, the duration of the block procedure was longer in the CSAPB application.

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“…Bukağıkıran et al (19) found that opioid consumption at the postoperative 24 th hour in patients undergoing thoracic surgery was significantly lower in the ESPB administered group than in the control group. There are studies in the literature demonstrating that both ESPB and TEA reduce opioid consumption in the postoperative period after thoracic surgery (20,21). However, the number of studies comparing these two blocks is limited.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Guided Erector Spinae Plane Block; an Alternative to Epidural Analgesia for Pain Management After Thoracotomy

ŞİMŞEK¹,

Turan²,

Kamburoğlu³

et al. 2023

hamidiyemedj

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Background: Severe postoperative pain may occur following thoracotomy. The sources of this pain often include multiple muscle incisions, chest drains and possible rib injury. The management of this pain is extremely important for rehabilitation in the postoperative period. Thoracic epidural analgesia (TEA) represents the "gold standard" of pain control. However, this approach has serious problems such as hypotension, urinary retention, and hematoma. The erector spinae plane block (ESPB) is a novel regional analgesia technique and it is a simple, safe and effective method that can be applied as an alternative. The aim of this study was to assess the analgesic effectiveness of the ESPB and TEA techniques after thoracotomy. Materials and Methods:This retrospective, single-center study conducted between October 2018 and September 2020. We evaluated 83 patients who received ESPB, TEA and conventional (non-regional) technique. Demographic data, operation type and duration, postoperative visual analog scale (VAS) scores, opioid consumption were obtained from anesthesia and clinical patient follow-up forms. Results:The study included 83 patients who underwent thoracotomy and were divided into three groups as group ESPB (28), group TEA (33) and group control (22) who did not apply any regional analgesia method. The VAS scores at the 8 th , 24 th and 48 th hours postoperatively, were found to be significantly lower in the ESPB and TEA groups compared to the control group (p<0.05). ESPB and TEA groups had similar levels of VAS scores and opioid consumption (p>0.05). Opioid consumptions of ESPB and TEA groups was significantly lower than that in the control group (p<0.05). Conclusion:ESPB, which provides a similar level of analgesia with TEA in the management of postoperative analgesia in thoracotomy, can be considered a good alternative regional analgesia technique especially in patients with additional comorbidities such as obesity and spinal deformity.

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Postoperative analgesic effectiveness of bilateral erector spinae plane block for adult cardiac surgery: a randomized controlled trial

Cited by 7 publications

References 25 publications

Erector Spinae Plane Block for Postoperative Analgesia in Cardiac Surgeries- A Systematic Review and Meta-Analysis

Erector Spinae Plane Block for Postoperative Analgesia in Cardiac Surgeries- A Systematic Review and Meta-Analysis

Comparison of deep and combined serratus anterior plane block after video-assisted thoracoscopic surgery; a prospective randomized trial

Ultrasound Guided Erector Spinae Plane Block; an Alternative to Epidural Analgesia for Pain Management After Thoracotomy

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