Comparison between the ultrasound-guided erector spinae block and the subcostal approach to the transversus abdominis plane block in obese patients undergoing sleeve gastrectomy: a randomized controlled trial

Abdelhamid, Bassant Mohamed; Khaled, Dalia; Mansour, M. A.; Hassan, Mohamed M.

doi:10.23736/s0375-9393.20.14064-1

Cited by 20 publications

(36 citation statements)

References 39 publications

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“…Eighteen studies reported postoperative pain score at rest 24 h after surgery 6,9,42,43,45–49,53–56,58–61,63 …”

Section: Resultsmentioning

confidence: 99%

“…Eleven studies evaluated the effect of erector spinae plane block on the number of patients requiring rescue analgesia after surgery 6,9,42,47,49–51,58,59,62,63 …”

Section: Resultsmentioning

confidence: 99%

“…Nine studies evaluated the difference in the time taken to administer the first rescue analgesia after surgery between the ESPB and control groups 6,9,43,51,52,56,57,62,63 …”

Section: Resultsmentioning

confidence: 99%

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Opioid‐sparing effects of ultrasound‐guided erector spinae plane block for adult patients undergoing surgery: A systematic review and meta‐analysis

et al. 2021

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Background Erector spinae plane block (ESPB) is a new method of administering analgesics to patients perioperatively. The aim of this meta‐analysis was to evaluate the opioid‐sparing effects of erector spinae plane block in patients during the perioperative period compared to conventional analgesia and identify its role in the development of opioid‐free anesthesia. Methods Relevant study articles were retrieved from PubMed, the Web of Science, Medline via Ovid, Embase via Ovid, and the Cochrane Central Register of Controlled Trials (CENTRAL) on June 11, 2020. We included randomized controlled trials (RCTs) comparing the use of ESPB with control (no/sham block). The primary outcome was opioid consumption at 24 h after surgery and intraoperative opioid consumption. A random‐effects model was used to calculate the standardized mean difference (SMD) and odds ratio (OR) with 95% confidence interval (CI) if there was significant heterogeneity in the data; otherwise, the fixed‐effect model was used. Results A total of 25 randomized controlled trials involving 1461 patients were included. The use of ultrasound‐guided ESPB was associated with reduced opioid consumption at 24 h after surgery [SMD: −2.14, 95% CI: −2.61 to −1.67, p < 0.001] and during the intraoperative period [SMD: −2.30, 95% CI: −3.21 to −1.40, p < 0.001]. In addition, it took a longer time to administer the first rescue analgesia in the ESPB group [SMD: 3.60, 95% CI: 2.23–4.97, p < 0.001] and the group was associated with lower incidences of postoperative nausea or vomiting (PONV) [OR: 0.50, 95% CI: 0.34–0.72, p < 0.001]. Conclusions Ultrasound‐guided ESPB could provide an opioid‐sparing effect and effective analgesia in adults undergoing surgeries with general anesthesia, and then promote opioid‐free anesthesia development.

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“…Eighteen studies reported postoperative pain score at rest 24 h after surgery 6,9,42,43,45–49,53–56,58–61,63 …”

Section: Resultsmentioning

confidence: 99%

“…Eleven studies evaluated the effect of erector spinae plane block on the number of patients requiring rescue analgesia after surgery 6,9,42,47,49–51,58,59,62,63 …”

Section: Resultsmentioning

confidence: 99%

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Opioid‐sparing effects of ultrasound‐guided erector spinae plane block for adult patients undergoing surgery: A systematic review and meta‐analysis

et al. 2021

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“…The results further showed that five studies compared the time to first request for rescue analgesia between ESPB and control groups (Figure 4) (15,16,(18)(19)(20). Here, we prefer the mean difference since all studies use the same unit (hours) and outcome (continuous).…”

Section: The First Request For Rescue Analgesia (In Hours)mentioning

confidence: 96%

Erector Spinae Plane Block in Abdominal Surgery: A Meta-Analysis

2022

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BackgroundAbdominal surgery is one of the most definitive and mainstay treatment options for abdominal pathologies in clinical practice. Acute postoperative pain is a major challenge in the postoperative period. Although opioids are commonly used for analgesia after major abdominal surgeries, they can lead to side effects, such as nausea and vomiting, constipation, pruritus, and life-threatening respiratory depression. Regional anesthetic techniques are commonly used to prevent or minimize these side effects. The objective of this meta-analysis is to assess the effectiveness of erector spinae plane block (ESPB) and standard medical (no block) pain management after major abdominal surgeries.MethodsWe searched for articles reporting the results of randomized controlled trials on ESPB and no block in pain control published before May 2021.ResultsThe systematic search initially yielded 56 publications, 49 articles were excluded, and seven randomized clinical trials were included and analyzed. We extracted the data on postoperative opioid consumption, the efficacy of pain relief, time to the first opioid demand, and the rate of postoperative complications in the ESPB group and no block group.ConclusionsOpioid requirement and time to first analgesic request were significantly reduced in the ultrasound-guided ESPB group, but pain scores, nausea, and vomiting did not differ significantly after pooling the results of the block and no block studies. There were no reports on serious complications related to ESPB.

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“…TAPB relieves pain after abdominal surgery by blocking the sensory nerve of the anterolateral abdominal wall (T6-L1) [ 12 ]. A large number of studies have confirmed that TAPB can provide safe and effective postoperative analgesia for patients undergoing a variety of abdominal surgeries, including laparoscopic cholecystectomies [ 13 ], hysterectomies [ 14 ], and gastrointestinal surgeries [ 15 ].…”

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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Comparison between the ultrasound-guided erector spinae block and the subcostal approach to the transversus abdominis plane block in obese patients undergoing sleeve gastrectomy: a randomized controlled trial

Cited by 20 publications

References 39 publications

Opioid‐sparing effects of ultrasound‐guided erector spinae plane block for adult patients undergoing surgery: A systematic review and meta‐analysis

Opioid‐sparing effects of ultrasound‐guided erector spinae plane block for adult patients undergoing surgery: A systematic review and meta‐analysis

Erector Spinae Plane Block in Abdominal Surgery: A Meta-Analysis

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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