Comparison of ultrasound-guided erector spinae plane block and thoracic paravertebral block for postoperative analgesia after laparoscopic nephrectomy: a randomized controlled non-inferiority clinical trial

Fan, Qingzhu; Liu, Hua; Li, Yanshuang; Dai, Hui; Wang, Yanping

doi:10.23736/s0375-9393.22.16794-5

Cited by 8 publications

(7 citation statements)

References 22 publications

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“…Very recently, Fan et al in their randomized controlled trial conducted in 61 patients found that ESPB provided non-inferior analgesia in patients who underwent laparoscopic nephrectomy surgery compared to thoracic paravertebral block [17]. In another randomized controlled trial in 186 patients who underwent laparoscopic nephro-ureterectomy, Xu et al reported the median (IQR) 24 hours cumulative sufentanyl equivalent dose was 15 (5-30) microgram and the median (IQR) time to rst patient controlled analgesia demand was 7 (4-18) hours in the ESPB group [18].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Ultrasound Guided Erector Spinae Plane Block Compared to Wound Infiltration for Postoperative Analgesia in Laparoscopic Live Donor Nephrectomy: A Double-Blinded Randomized Controlled Trial

Loganathan,

Kajal,

Garg

et al. 2024

Preprint

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Background Postoperative pain remains a significant problem in patients undergoing donor nephrectomy despite reduced tissue trauma following laparoscopic live donor nephrectomy (LLDN). Inadequately treated pain leads to physiological and psychological consequences, including chronic neuropathic pain. Materials and Methods This randomized controlled double-blinded trial was conducted in sixty-nine (n=69) participants who underwent LLDN under general anesthesia. Participants were randomized into Group B (n=34) and Group C (n=35). Group B received ultrasound-guided bilateral erector spinae plane block (ESPB) with bupivacaine 0.125% 20ml on the surgical side and 10ml on the contralateral side at T9-10 level before extubation, while Group C received wound infiltration with bupivacaine 0.125% 15ml. The primary objective of the study was to compare cumulative 24-hour morphine consumption postoperatively. The secondary objectives were time to first rescue analgesia, visual numeric rating scale (VNRS) pain scores at rest and during movement, incidence of postoperative nausea and vomiting (PONV), and complications associated with ESPB. Results Participants in Group B required significantly less median (IQR) 24-hour morphine compared to Group C [6 (6-9) mg vs 15 (12-15) mg; median difference 9; 95% CI in median difference 6-12; p<0.001), longer median (IQR) time to first rescue analgesia [6 (6-8) hours vs 1 (1-2) hours; p < 0.001], and lower VNRS at rest and during movement at baseline, 0.5, 1, 2, 4, 6, 8, 12, 24 hours. Conclusion Ultrasound-guided ESPB provided effective pain relief compared to wound infiltration with local anaesthetic in patients who underwent LLDN. Trial Registration number: INT/IEC/2021/SPL-514; CTRI/2021/07/045909

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Section: Discussionmentioning

confidence: 99%

Efficacy of Ultrasound Guided Erector Spinae Plane Block Compared to Wound Infiltration for Postoperative Analgesia in Laparoscopic Live Donor Nephrectomy: A Double-Blinded Randomized Controlled Trial

Loganathan,

Kajal,

Garg

et al. 2024

Preprint

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“…18 ESPB provided noninferior analgesia for pain at rest within 24 postoperative hours in comparison to thoracic paravertebral block for laparoscopic nephrectomy. 19,20 Epidural is contraindicated in patients with thrombocytopenia, coagulopathy, or anticoagulant therapy. ESPB, by continuous infusion, has proven to be a useful substitute in pediatric liver transplantation.…”

Section: Abdominal Surgerymentioning

confidence: 99%

“…In another study 18 . ESPB provided noninferior analgesia for pain at rest within 24 postoperative hours in comparison to thoracic paravertebral block for laparoscopic nephrectomy 19, 20 …”

Section: Indications and Usesmentioning

confidence: 99%

Erector spinae plane blocks: A narrative update

Bosenberg

2023

Pediatric Anesthesia

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The erector spinae plane block (ESPB) is perhaps one of the most interesting of the tissue plane blocks described recently. There has been an exponential increase in the number of publications for both adults and children over the past 5 years. Single‐shot, intermittent bolus, and continuous infusion techniques have been used effectively. Both the efficacy and safety of the procedure are widely accepted, but the exact mechanism by which the local anesthetic spreads from the tip of the transverse process to block the dorsal and ventral rami of the spinal nerves is controversial and needs clarification. Anatomical differences in children, particularly in neonates and infants, may explain the spread in this age group. In most pediatric studies, erector spinae plane block was opioid sparing, and noninferiority was observed when compared with other regional techniques.

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“…[ 4 ] Thus, a non-inferiority margin of 1.0 points is often selected in randomised controlled non-inferiority trials comparing the postoperative analgesic efficacy of different regional blocks. [ 5 6 ]…”

mentioning

confidence: 99%

“…In designing a randomised controlled non-inferiority trial, the non-inferiority margin is actually the effect size and is used for sample size evaluation[ 3 ] as performed in other works. [ 5 6 ]…”

mentioning

confidence: 99%

Research design is important in comparing the analgesic efficacy of different regional blocks following modified radical mastectomy

Yang,

Li,

Xue

2024

Indian Journal of Anaesthesia

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Comparison of ultrasound-guided erector spinae plane block and thoracic paravertebral block for postoperative analgesia after laparoscopic nephrectomy: a randomized controlled non-inferiority clinical trial

Cited by 8 publications

References 22 publications

Efficacy of Ultrasound Guided Erector Spinae Plane Block Compared to Wound Infiltration for Postoperative Analgesia in Laparoscopic Live Donor Nephrectomy: A Double-Blinded Randomized Controlled Trial

Efficacy of Ultrasound Guided Erector Spinae Plane Block Compared to Wound Infiltration for Postoperative Analgesia in Laparoscopic Live Donor Nephrectomy: A Double-Blinded Randomized Controlled Trial

Erector spinae plane blocks: A narrative update

Research design is important in comparing the analgesic efficacy of different regional blocks following modified radical mastectomy

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