No abstract

Objectives: Due to the complex breast innervation, postoperative analgesia after breast surgery is a challenge for the anesthesiologists. The erector spinae plane block (ESPB) is a newly defined promising technique for this purpose. The main purpose of this study was to evaluate the analgesic efficacy of the ultrasound-guided ESPB in breast surgery, monitoring its effect on the postoperative opioid consumption. Methods: Fifty female patients, who were scheduled to undergo elective breast surgery, with the American Society of Anesthesiology physical score I-II, and aged between 25 and 70 years, were included into the study. Patients were randomized into two groups, as the ESPB and the control group. All patients in the ESPB group received a bi-level (T2-T4) ultrasound-guided ESPB with 20 ml 0.25 % bupivacaine (10 ml for each level) preoperatively. An intravenous patient-controlled analgesia device for the postoperative analgesia was given to all patients. The numeric rating scale (NRS) scores for pain and postoperative morphine consumptions were recorded at the 1 st , 6 th , 12 th , and 24 th hour postoperatively. Results: Postoperative morphine consumption was significantly lower in the ESPB group compared to the control group at the postoperative 6 th , 12 th , and 24 th hour (p<0.001 for each time interval). The morphine consumption at the 24-hour was reduced by 75%. There was no significant difference in the NRS scores (median NRS values were 2, 1, 0, 0, and 2, 2, 1, 1, respectively). Conclusion:Our study has shown that a significant opioid-sparing analgesic effect in patients undergoing breast surgery could be achieved with a US-guided bi-level ESP block.

Objective: Erector spinae plane block (ESP) is a novel technique for postoperative pain management. Primary aim of this study is to evaluate efficacy of ultrasound -guided ESP for providing postoperative analgesia in laparoscopic cholecystectomy (LC) procedures. Methods: Forty-six ASA I-II patients aged 20-70, who were scheduled to undergo elective LC were included in the study. Patients were randomized into two groups as ESP and Control group. Patients in the ESP group received ultrasound (US)-guided ESP block with 20 ml 0.25% bupivacaine. An intravenous patient-controlled analgesia device containing morphine was provided for all the patients in both groups. Morphine consumptions at postoperative 24 th hour and postoperative numeric rating scale (NRS) scores for pain were recorded. Results: Mean morphine consumptions at postoperative 24 th hour were 7.5 mg±5.8 in the ESP group while it was 13.2±5.6 mg in the control group (p<0.01). There was also a significant difference between the groups as for NRS scores at 12 th and 24 th hours (p=0.016, p=0.003 respectively). None of the patients in the ESP group complained about shoulder pain; but in the control group 9 patients reported shoulder pain. Conclusion:This study has shown that ESP block at T8 level has reduced the opioid consumption and showed a significant analgesic effect in patients undergoing LC.

No abstract

This report was submitted to share an experience of the development of a local hematoma as a complication following ultrasound-guided popliteal block performance in a 92-year-old, American Society of Anaesthesiologists class III, male patient undergoing surgical excision of a malignant melanoma lesion in the base of the left foot performed by the plastic surgery department.