The effect of erector spinae plane block on postoperative analgesia and respiratory function in patients undergoing laparoscopic cholecystectomy: A double-blind randomized controlled trial

Yildiz, Munise; Kozanhan, Betül; İyisoy, Mehmet Sinan; Canitez, Ahmet; Aksoy, Nergis; Eryigit, Aysenur

doi:10.1016/j.jclinane.2021.110403

Cited by 23 publications

(11 citation statements)

References 22 publications

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“…The main sources of bias from the included studies were the lack of a description of participant and personnel blinding. (25,26,28,33,37,40,(42)(43)(44) for LC, in four studies (27,31,34,41) for PCNL, in three studies (23, 38, 45) for BS, in two studies (30, 36) for laparoscopic hepatectomy (LH), in two studies (32, 35) for total abdominal hysterectomy, in one study (22,24) for hernia repair, in one study (22) for open nephrectomy, in one study (29) for open radical prostatectomy and in one study (39) for emergency laparotomy. Moreover, in the majority (20 of the 24) of the studies (22-27, 29-34, 36-40, 42, 43, 45), ESPB was performed before the surgery.…”

Section: Resultsmentioning

confidence: 99%

“…There were twenty RCTs ( 22 – 25 , 27 – 32 , 34 , 36 – 39 , 41 – 45 ) that compared ESPB with placebo, six studies ( 23 , 26 , 33 , 35 , 39 , 40 ) that compared ESPB with TAPB. Abdominal surgeries were performed under general anesthesia in all studies: in nine studies ( 25 , 26 , 28 , 33 , 37 , 40 , 42 – 44 ) for LC, in four studies ( 27 , 31 , 34 , 41 ) for PCNL, in three studies ( 23 , 38 , 45 ) for BS, in two studies ( 30 , 36 ) for laparoscopic hepatectomy (LH), in two studies ( 32 , 35 ) for total abdominal hysterectomy, in one study ( 22 , 24 ) for hernia repair, in one study ( 22 ) for open nephrectomy, in one study ( 29 ) for open radical prostatectomy and in one study ( 39 ) for emergency laparotomy. Moreover, in the majority (20 of the 24) of the studies ( 22 – 27 , 29 – 34 , 36 – 40 , 42 , 43 , 45 ), ESPB was performed before the surgery.…”

Section: Resultsmentioning

confidence: 99%

“…In the subgroup analysis of LC, five trials ( 25 , 28 , 37 , 43 , 44 ) reported that, compared with placebo, ESPB significantly reduced pain scores at 6 h (−1.42 cm; 95% CI −2.23 to −0.60; P = 0.0006; I 2 = 91%) and 24 h (−0.98 cm; 95% CI −1.74 to −0.21; P = 0.01; I 2 = 89%) ( Table 3 ). Interestingly, five trials ( 25 , 28 , 37 , 43 , 44 ) showed that no significant difference was detected in postoperative pain scores at 12 h (−0.62 cm; 95% CI −1.39 to 0.15; P = 0.11; I 2 = 90%) between the groups ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

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Postoperative analgesia efficacy of erector spinae plane block in adult abdominal surgery: A systematic review and meta-analysis of randomized trials

Gao

Liu²,

Cui³

et al. 2022

Front. Med.

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ObjectivesErector spinae plane block (ESPB) has been used for many thoracic and abdominal surgeries. However, evidence of its analgesic efficacy following abdominal surgery, compared with that of thoracic analgesia, is insufficient. Our study explored the analgesic effect of ESPB after abdominal surgery.MethodsWe searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. Primary outcomes were pain scores at 6, 12 and 24 h and 24-h opioid consumption. Secondary outcomes included time to first rescue analgesia, length of hospital stay, and incidence of postoperative nausea and vomiting (PONV). We calculated standardized mean differences (SMDs) with 95% confidence intervals (CIs) for primary outcomes and mean differences (MDs) and risk ratios (RRs) with 95% CIs for secondary outcomes.ResultsWe systematically included 1,502 cases in 24 trials. Compared with placebo, ESPB significantly reduced pain scores at 6 h (SMD −1.25; 95% CI −1.79 to −0.71), 12 h (SMD −0.85; 95% CI −1.33 to −0.37) and 24 h (SMD −0.84; 95% CI −1.30 to −0.37) and 24-h opioid consumption (SMD −0.62; 95% CI −1.19 to −0.06) post-surgery. ESPB prolonged the time to first rescue analgesia and decreased the incidence of PONV. Compared with transversus abdominal plane block (TAPB), ESPB significantly reduced pain scores at 6, 12, and 24 h and 24-h opioid consumption and prolonged the time to first rescue analgesia postsurgically. Furthermore, subgroup analysis showed that ESPB significantly reduced pain scores at various time points and opioid consumption within 24 h after laparoscopic cholecystectomy, percutaneous nephrolithotomy and bariatric surgery.ConclusionCompared with placebo, ESPB improves the postoperative analgesic efficacy after abdominal surgery. Furthermore, our meta-analysis confirmed that ESPB provides more beneficial analgesic efficacy than TAPB.Systematic review registration[https://www.crd.york.ac.uk/PROSPEROFILES/301491_STRATEGY_20220104.pdf], identifier [CRD42022301491].

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Postoperative analgesia efficacy of erector spinae plane block in adult abdominal surgery: A systematic review and meta-analysis of randomized trials

Gao

Liu²,

Cui³

et al. 2022

Front. Med.

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“…Singh et al [ 13 ] also observed that 24h morphine consumption was less in the group who received US-guided ESP block when compared with the control group (p = 0.01). Yildiz et al [ 14 ] observed that the total amount of tramadol consumed in the first 24 hours was lower in Group E than in the control group (p < 0.01). Ciftci et al [ 15 ] observed that postoperative fentanyl consumption was significantly lower in the ESPB group than in the sham block group (p = 0.009).…”

Section: Discussionmentioning

confidence: 99%

Randomized Comparative Study Between Bilateral Erector Spinae Plane Block and Transversus Abdominis Plane Block Under Ultrasound Guidance for Postoperative Analgesia After Total Abdominal Hysterectomy

Shukla¹,

Yadav²,

Singh³

et al. 2022

Cureus

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Introduction: Ultrasound-guided erector spinae plane (ESP) block has emerged as an effective and safe analgesic regional technique and it also provides visceral pain relief. Our aim was to compare the analgesic efficacy of ESP block over transversus abdominis plane (TAP) block under ultrasound guidance following a total abdominal hysterectomy. Methods: This was a prospective, randomized, comparative study. Thirty females posted for elective open total abdominal hysterectomy under general anesthesia were randomly allocated into two groups. Ultrasound-guided ESP block was applied in group E at the T-9 level bilaterally. The study solution was prepared by mixing 20 ml of 0.5% bupivacaine plus 10 ml of 2% lignocaine and 1 ml (50mcg) of fentanyl and 9 ml of normal saline forming total 40 ml of which 20 ml was injected on each side. Group T received ultrasound-guided TAP block with 20 ml of study solution bilaterally. The study solution was prepared similarly by mixing 20 ml of 0.5% bupivacaine plus 10 ml of 2% lignocaine and 1 ml (50mcg) of fentanyl and 9 ml of normal saline (total 40 ml) of which 20 ml was injected into each side. Tramadol 100mg iv was given as rescue analgesia whenever NRS ≥ 4 or on-demand in the postoperative period. The primary outcome was changes in a numerical rating scale (NRS) pain score postoperatively between two groups in 24 h, duration of analgesia and total rescue analgesic required during 24 h. The secondary outcome was patient satisfaction level and side effects if any. Results: Demographic data were comparable in both groups. The NRS pain score was significantly lower in group E than in group T at second, third, fourth, fifth (p < 0.001) and at sixth hour (p < 0.05) postoperatively. The mean duration of analgesia was significantly more in Group E (4.73±0.7 h) compared to group T (2.60±0.51 h) (p < 0.001). The tramadol consumption was seen significantly more in 24 h in group T (233.33±25.82 mg) than in group E (193.33±17.59 mg). Patient satisfaction score was significantly higher at 12 h with mean value of 6.07±0.26 in group E compared to 3.40±0.91 in group T. Conclusion: We conclude that ultrasound-guided ESP block provide better postoperative pain control and prolonged duration of analgesia with less tramadol consumption compared to ultrasound-guided TAP block in patients after total abdominal hysterectomy.

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“…Although ESPB was first used for chronic pain, it has now been widely employed as a postoperative analgesia in a variety of surgeries involving the shoulder and hip regions [ 17 , 18 ]. Recent studies have demonstrated that ESPB plays an important role in analgesia after abdominal surgeries [ 19 , 20 ]. However, there are still few studies focusing on the use of ESPB for postoperative analgesia in elderly patients after abdominal surgeries.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Ultrasound-Guided Erector Spinae Plane Block and Oblique Subcostal Transverse Abdominis Plane Block for Postoperative Analgesia in Elderly Patients After Laparoscopic Colorectal Surgery: A Prospective Randomized Study

et al. 2021

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Introduction: Postoperative analgesia in elderly patients is still a thorny problem. Ultrasoundguided oblique subcostal transverse abdominis plane block (TAPB) has been demonstrated to provide postoperative analgesia after abdominal surgeries. However, recent studies have suggested that an alternative method, erector spinae plane block (ESPB), might also be effective. In this study, we compared the postoperative analgesic effects of ESPB and TAPB in elderly patients who had undergone laparoscopic colorectal surgery. Methods: Sixty-two elderly patients (C 65 years old) scheduled for elective laparoscopic colorectal surgery with general anesthesia were randomly allocated to two equally sized groups: ESPB group and TAPB group. The ESPB group had a bilateral erector spinae plane block, and the TAPB group had a bilateral oblique subcostal transverse abdominis plane block. The primary outcome was visual analogue scale (VAS) pain score during the first 24 postoperative hours at resting and active states. The secondary outcomes were postoperative consumption of sufentanil, satisfaction score, the number of patients who required antiemetics, incidence of block-related complications, and other side events. Results: There were no demographic differences between two groups. Compared to the TAPB group, the ESPB group had lower VAS pain scores and sufentanil consumption during the first 24 postoperative hours. Additionally, ESPB reduced the occurrence of postoperative nausea and vomiting. Furthermore, the satisfaction score was higher in the ESPB group. No other complications were reported between the two groups. Conclusions: Compared with oblique subcostal TAPB, ESPB more effectively reduced postoperative pain and opioid consumption. Thus, ESPB is suitable for postoperative analgesia in elderly patients who have undergone laparoscopic colorectal surgery.

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The effect of erector spinae plane block on postoperative analgesia and respiratory function in patients undergoing laparoscopic cholecystectomy: A double-blind randomized controlled trial

Cited by 23 publications

References 22 publications

Postoperative analgesia efficacy of erector spinae plane block in adult abdominal surgery: A systematic review and meta-analysis of randomized trials

Postoperative analgesia efficacy of erector spinae plane block in adult abdominal surgery: A systematic review and meta-analysis of randomized trials

Randomized Comparative Study Between Bilateral Erector Spinae Plane Block and Transversus Abdominis Plane Block Under Ultrasound Guidance for Postoperative Analgesia After Total Abdominal Hysterectomy

Comparison of Ultrasound-Guided Erector Spinae Plane Block and Oblique Subcostal Transverse Abdominis Plane Block for Postoperative Analgesia in Elderly Patients After Laparoscopic Colorectal Surgery: A Prospective Randomized Study

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