Investigation of the effect of ultrasonography-guided bilateral erector spinae plane block on postoperative opioid consumption and pain scores in patients undergoing hepatectomy: a prospective, randomized, controlled study

Abstract

INTRODUCTIONHepatectomy is a commonly used treatment option for many benign or malignant liver diseases. 1 Bilateral subcostal incision, surgical retraction and large liver resection, which are all used in hepatectomy surgery, lead to severe postoperative pain in the lower thoracic and abdominal region.Postoperative analgesia for patients who underwent hepatectomy in protocols for enhanced recovery after surgery (ERAS) is one of the issues which are still discussed and waiting for a solution. 2 The use of intravenous (iv) patient-controlled analgesia (iv PCA) has been demonstrated to be effective in postoperative analgesia, but it should not be ignored that drug metabolism will be influenced in this patient group due to hepatectomy. For this reason, use of multimodal analgesia methods is thought to form a correct approach towards reducing iv opioid consumption. 3 Epidural analgesia provides effective postoperative analgesia following abdominal surgery.However, the changes in coagulation parameters after hepatectomy may pose a risk in patients with epidural catheters. 4 For this reason, safer but easily applicable alternatives are needed for patients who will undergo hepatectomy.Erector spinae plane (ESP) block is a plane block that was first defined for treating thoracic neuropathic pain and later used for postoperative analgesia in abdominal surgery.

Efficacy of ultrasound-guided erector spinae plane block versus paravertebral block for postoperative analgesia in single-port video-assisted thoracoscopic surgery: a retrospective study

“…The erector spinae plane block (ESPB) is a new technique that is easier to visualize and perform because it is more superficial. Owing to these advantages, it has been preferred frequently for postoperative analgesia in different types of operations such as thorax, abdomen, hip, and lumbar surgeries in recent years (7)(8)(9)(10).…”