A new indication of erector spinae plane block for perioperative analgesia is total hip replacement surgery – A case report

Singh, Swati; Ranjan, Rahul; Lalin, Dusu

doi:10.4103/ija.ija_25_19

Cited by 12 publications

(6 citation statements)

References 11 publications

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“…is is one of the few randomized controlled trials to evaluate the use of lumbar ESPB for analgesia in total hip arthroplasty. In terms of efficacy, our results are consistent with recent case reports and observational studies of ESPB utilized in hip surgeries, only one of which pertains specifically to total hip arthroplasties [5][6][7][8][9]. e most similar study was performed by Ahiskalioglu et al, who demonstrated that deposition of 40 ml of a local anesthetic mixture (20 ml 0.5% bupivacaine, 10 ml lidocaine 2%, and 10 ml normal saline) between the erector spinae and L4 transverse process for both hemiarthroplasties and intramedullary femur nailing resulted in adequate analgesia with a median time of 8 hours [8].…”

Section: Discussionsupporting

confidence: 90%

“…Since then, there have been studies demonstrating its efficacy with a thoracic approach for analgesia in breast surgery and rib fractures [4]. Only a few case reports to date have demonstrated a lumbar approach to achieve analgesia for hip arthroplasty [5][6][7]. Two major benefits to this block are its relatively low risk of complications due to its anatomical position [5], as well as the lack of risk of mechanical nerve damage as there is no direct contact with any nerves [6].…”

Section: Introductionmentioning

confidence: 99%

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Lumbar Erector Spinae Plane Block for Total Hip Arthroplasty Comparing 24-Hour Opioid Requirements: A Randomized Controlled Study

Townsend

Siddique

Kimura

et al. 2022

Anesthesiology Research and Practice

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Study Objective. Neuraxial and regional anesthesia have become commonly utilized for patients undergoing total hip arthroplasty to aid in postoperative analgesia, facilitating early ambulation and better functional recovery. This study investigated the efficacy of a lumbar erector spinae plane block (ESPB) on reducing postoperative opioid consumption in total hip arthroplasty performed under spinal anesthesia. Design. Prospective, randomized, controlled trial. Patients. Sixty-three adult patients with an American Society of Anesthesiologists Status I–III who are undergoing elective primary total hip arthroplasty. Interventions. Patients were randomized to the control group (no block) or the ESPB group (preoperative ultrasound-guided lumbar ESPB). Intraoperatively, all patients received spinal anesthesia with moderate sedation. Postoperatively, patients received a standardized multimodal analgesia protocol. Measurements. The primary outcome was cumulative opioid consumption at 24 hours postoperatively. Secondary outcomes included cumulative opioid consumption at 8 hours and through 48 hours postoperatively and pain scores at 24 and 48 hours post surgery. Main Results. Thirty-one patients were randomized to the control group (spinal alone) and 32 patients to the ESPB group. The median opioid requirement in the first 8 hours after surgery was higher in the control group (28 mg of oral morphine equivalents (OME) versus 5 mg of OME in the ESPB group) ( p = 0.013 ). There was no statistically significant difference in opioid consumption between the groups at 24 hours ( p = 0.153 ) or 48 hours ( p = 0.357 ) postoperatively. There was no statistically significant difference in pain scores between the two groups through 24 hours ( p = 0.143 ) or 48 hours ( p = 0.617 ) after surgery. Conclusion. Lumbar ESPB reduces opioid utilization during the first 8 hours postoperatively after total hip arthroplasty but not thereafter. Evaluating the use of either adding a local anesthetic adjunct to the ESPB or using longer-acting local anesthetic warrants further investigation.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Lumbar Erector Spinae Plane Block for Total Hip Arthroplasty Comparing 24-Hour Opioid Requirements: A Randomized Controlled Study

Townsend

Siddique

Kimura

et al. 2022

Anesthesiology Research and Practice

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“…Since then, other authors have also published case reports of lumbar ESPB for THA with favourable outcomes [26,27]. Continuous ESPB catheters have also been used for postoperative analgesia in THA [28,29]. In 2020, Ahiskalioglu et al conducted an observational study on fifteen high risk elderly patients undergoing hip surgery and demonstrated that lumbar ESPB when combined with mild propofol sedation provides adequate and safe anaesthesia for hip surgery.…”

Section: Newer Regional Anaesthesia Techniques (Table-5) a Supraingui...mentioning

confidence: 99%

Current Concepts in Postoperative Pain Management Surgeries of Hip Joint: A Narrative Review

Gupta¹,

Kaushal²,

Malviya³

et al. 2022

IJRA

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Hip surgery is a common surgical procedure in the elderly and leads to significant pain postoperatively. The hip joint has a complex innervation which is unlikely to be covered with any single modality of pain relief. Multimodal analgesia has been critical in facilitating early recovery and rehabilitation in these patients. Regional analgesia is an important component of multimodal analgesia regimens and is instrumental in achieving optimal patient outcomes. Single shot or continuous central or peripheral nerve blocks provide effective and safe postoperative analgesia, lower opioid consumption, faster rehabilitation, and a high level of patient satisfaction. An ideal regional anaesthesia technique for hip surgery should be motor sparing while providing effective perioperative pain relief. Regional anaesthesia has seen enormous growth in the recent past due to advances in technology and research. These blocks have shown analgesic efficacy, have an opioid-sparing effect, and enable better patient positioning for central neuraxial blocks. Some of the novel interfascial plane blocks like Pericapsular Nerve Group (PENG) block are now being explored for hip analgesia. Within a few years of being described, these novel nerve blocks have seen tremendous favour in the literature and are being extensively used in the current practice of analgesia for hip surgery. In the present review, we aim to discuss the various modalities of analgesia which have been utilised in the past and would discuss few of the newer blocks for hip surgery. Keywords: Nerve blocks, Ultrasonography, Analgesics, Total hip arthroplasty, Fascia illiaca block, Multimodal analgesia, Transmuscular, Quadratus lumborum block

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“…Lumbar ESPB was first described for hip surgery 8 and later for use in hip and femur surgery. 17,24,25,29,39,[64][65][66][67][68] Radiological evaluation and clinical results have shown that high volume lumbar ESPB results in similar analgesia as lumbar plexus block. 29,32 It has also been reported for the postoperative analgesia of knee surgery.…”

Section: Orthopedic Proceduresmentioning

confidence: 99%

<p>Anesthetic Techniques: Focus on Lumbar Erector Spinae Plane Block</p>

Tulgar¹,

Aydın²,

Ahıskalıoğlu³

et al. 2020

LRA

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Defined in the last decade, erector spinae plane block (ESPB) is one of the more frequently used interfacial plans, and it has been the most discussed block among the recently defined techniques. Lumbar ESPB administered at lumbar levels is relatively novel and is a new horizon for regional anesthesia and pain practice. In this article, we aim to explain and introduce different approaches and explain the possible mechanism of action of lumbar ESPB. The objective of this review is to analyze the case reports, clinical and cadaveric studies about lumbar ESPB that have been published to date. We performed a search in "Pubmed" and "Google Scholar" database. After a selection of the relevant studies, 59 articles were found eligible and were included in this review. While we believe that lumbar ESPB is reliable and easy, we suggest that its efficacy and indications should be verified with anatomical and clinical studies, and its safety should be confirmed with pharmacokinetic studies. Moreover, the possibility of complications must be considered.

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A new indication of erector spinae plane block for perioperative analgesia is total hip replacement surgery – A case report

Abstract: A new indication of ultrasound – guided Erector spinae plane block for perioperative analgesia is orthopaedic surgery. We report here the use of this paraspinal block in the case of a 68-yr-old female with multiple systemic disorder for total hip replacement surgery.

Cited by 12 publications

References 11 publications

Lumbar Erector Spinae Plane Block for Total Hip Arthroplasty Comparing 24-Hour Opioid Requirements: A Randomized Controlled Study

Lumbar Erector Spinae Plane Block for Total Hip Arthroplasty Comparing 24-Hour Opioid Requirements: A Randomized Controlled Study

Current Concepts in Postoperative Pain Management Surgeries of Hip Joint: A Narrative Review

<p>Anesthetic Techniques: Focus on Lumbar Erector Spinae Plane Block</p>

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