Erector Spinae Block a safe, simple and effective analgesic technique for major hepatobiliary surgery with thrombocytopenia

Ayub, Arshad; Talawar, Praveen; Kumar, Rakesh; Bhoi, Debesh; Singh, Ajay

doi:10.1016/j.egja.2018.08.001

Cited by 7 publications

(7 citation statements)

References 16 publications

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“…In-hospital use has been described in coagulopathic patients without complications. 9,10 The underlying bony anatomy makes identification of the target area easy and protects underlying structures from damage should needle placement be off target. Reported complications include pneumothorax, 11 incomplete blockade, 12 and motor block.…”

Section: Discussionmentioning

confidence: 99%

Erector Spinae Block for Chest Trauma in Aeromedical Prehospital and Retrieval Medicine

Ibbotson

Greenberg

Brendt

2020

Prehosp. Disaster med.

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Pain management for patients with chest trauma in aeromedical prehospital and retrieval medicine is important in order to maintain respiratory function. However, it can be challenging to achieve with opioids alone due to side effects including sedation, respiratory depression, and nausea.Reported are two trauma patients with uncontrolled pain despite multiple doses of opioids managed with a single-injection erector spinae plane block (ESB).The sono-anatomy and performance of the block, indications, and possible complications associated with the ESB are described.An ultrasound-guided ESB is useful for multimodal pain therapy following chest trauma in aeromedical retrieval medicine.

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Section: Discussionmentioning

confidence: 99%

Erector Spinae Block for Chest Trauma in Aeromedical Prehospital and Retrieval Medicine

Ibbotson

Greenberg

Brendt

2020

Prehosp. Disaster med.

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“…Pain is caused by the sub-costal J-shaped incision, the retraction of ribs, and diaphragmatic irritation. Adequate analgesia is important since inadequate pain control can lead to an increased risk of atelectasis, respiratory failure, and prolonged stay in the hospital [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Continuous Thoracic Epidural With Erector Spinae Block for Postoperative Analgesia in Adult Living Donor Hepatectomy

Zubair¹,

Khan²,

Khan³

et al. 2022

Cureus

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Background: Thoracic epidural analgesia (TEA) is commonly used for pain management in donor hepatectomy. Erector spinae plane block (ESPB) is a newer ultrasound-guided block described for the management of thoracic and abdominal pain. There is limited literature available comparing the two techniques. The objective of this study was to compare the postoperative analgesic efficacy and adverse effects of continuous ESPB to continuous TEA in donor hepatectomy.Methodology: The randomized controlled trial (RCT) was registered on ClinicalTrials.gov (NCT04151511). A total of 82 patients undergoing donor hepatectomy between January 2020 and December 2020 were recruited, of whom 41 received TEA and 41 received ESPB. Randomization was done by the sealed opaque envelope method.Results: The mean visual analog scale (VAS) scores in donors who received TEA and ESPB in post-anesthesia care unit (PACU) (2.7 + 0.9 vs. 2.4 + 0.5; P = 0.02) at one hour (2.7 + 0.9 vs. 2.2 + 0.6; P = 0.008), six hours (1.8 + 0.9 vs. 0.8 + 0.5; P < 0.001), 12 hours (0.9 + 0.7 vs. 0.2 + 0.7; P < 0.001), and 24 hours (0.48 + 0.5 vs. 0.08 + 0.3; P < 0.001) were significantly different. Mean opioid consumption was 3.38 ± 6.24 mg in the ESPB group and 10.75 ± 9.64 mg in the TEA group (P < 0.001). Mean lung volume (MLV) at 24 hours in the TEA group and ESPB group was 1543 ml and 1815 ml (P < 0.001). MLV was 2545 ml in the TEA group and 2820 ml in the ESPB group at 48 hours (P < 0.001). Mean nausea and vomiting score at six hours was 0.1 vs. 0.03 (P = 0.02).Conclusion: ESPB improves pain control after donor hepatectomy with an enhanced safety profile and reduced opioid consumption.

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“…Many recently published studies have reported the favourable effects of ESPB as postoperative analgesia in different types of surgery, such as breast surgery, abdominal surgery, thoracic surgery and hip reconstructions. However, few of these studies assessed the effect of ESPB as postoperative analgesia in spine surgery, and most of these studies were done on a small number of patients that were not fully blinded to the study [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Effect of bilateral ultrasound-guided erector spinae blocks on postoperative pain and opioid use after lumbar spine surgery: A prospective randomized controlled trial

Wahdan

Radwan

Mohammed

et al. 2021

Egyptian Journal of Anaesthesia

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Background: The control of postoperative pain following major lumbar spine surgeries remains a major challenge for anesthesiologists, and many new strategies and methods have been developed for pain control. This study's main objective was to evaluate the efficacy of the bilateral ultrasound-guided erector spinae plane block (US-ESPB) as a method for perioperative pain management in patients undergoing lumbar spine surgeries. Methods: This double-blinded prospective randomised controlled study was conducted on 140 patients aged between 18 and 65 years; all were scheduled for elective lumbar spine surgeries. Patients were randomly allocated into one of the two groups: the ESPB group (n = 70) or the control group (n = 70). All patients received bilateral US-ESPB after induction of general anaesthesia, in the ESPB group; 20 mL of levobupivacaine 0.25% were used, while 20 mL normal saline was given to the control group instead. The primary endpoint was the total amount of morphine consumed during the intraoperative and the first 24 postoperative hours. Secondary endpoints included, time to first request of rescue analgesia as well as incidence of adverse effects. Results: The total amount of morphine consumed during the intraoperative and the first 24 postoperative hours was found to be significantly lower in the ESPB group compared to the control group (P < 0.001). Moreover, the time to first analgesic request was significantly longer in patients receiving ESPB as analgesia (P < 0.001). No statistically significant differences were observed between the two groups regarding complications. Conclusion: Bilateral US-ESPB is useful intervention for providing adequate pain management in lumbar spine surgeries.

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Erector Spinae Block a safe, simple and effective analgesic technique for major hepatobiliary surgery with thrombocytopenia

Cited by 7 publications

References 16 publications

Erector Spinae Block for Chest Trauma in Aeromedical Prehospital and Retrieval Medicine

Erector Spinae Block for Chest Trauma in Aeromedical Prehospital and Retrieval Medicine

Comparison of Continuous Thoracic Epidural With Erector Spinae Block for Postoperative Analgesia in Adult Living Donor Hepatectomy

Effect of bilateral ultrasound-guided erector spinae blocks on postoperative pain and opioid use after lumbar spine surgery: A prospective randomized controlled trial

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