Erector Spinae Plane Block and Chronic Pain: An Updated Review and Possible Future Directions

De Cassai, Alessandro; Geraldini, Federico; Freo, Ulderico; Boscolo, Annalisa; Pettenuzzo, Tommaso; Zarantonello, Francesco; Sella, Nicolò; Tulgar, Serkan; Busetto, Veronica; Negro, Sebastiano; Munari, Marina; Navalesi, Paolo

doi:10.3390/biology12081073

Cited by 1 publication

(1 citation statement)

References 72 publications

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“…Erector spinae plane block (ESPB) is a novel trunk block, initially described by Forero et al in 2016 for the relief of chronic neuropathic pain [4]. Since then, it has gained prominence as a regional anesthesia technique with the potential to revolutionize postoperative pain management, and it has been effectively administered not only for the management of perioperative pain for a wide variety of surgeries [5] but also for the management of acute post-traumatic pain [6] and chronic pain [7]. While the ESPB has exhibited efficacy in various surgical and nonsurgical procedures, its application and efficacy in colorectal surgery remains an area of growing interest.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Ultrasound-Guided, Continuous, Bilateral Erector Spinae Plane Block in Perioperative Pain Management of Patients Undergoing Colorectal Surgery: A Randomized, Controlled, Double Blind, Prospective Trial

Sifaki,

Vogiatzaki,

Mantzoros

et al. 2023

JCM

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Open and laparoscopic colorectal surgeries, while essential in the management of various colorectal pathologies, are associated with significant postoperative pain. Effective perioperative pain management strategies remain an anesthesiologic challenge. The erector spinae plane block (ESPB), a novel peripheral nerve block, has gained attention for its potential in providing analgesia for a wide variety of surgeries. This study aimed to evaluate the effectiveness of continuous, bilateral ultrasound-guided ESPB in perioperative pain management of patients undergoing colectomy. This prospective, randomized, controlled, double-blind trial included 40 adult patients scheduled for elective open or laparoscopic colectomy. Patients undergoing open colectomy as well as patients undergoing laparoscopic colectomy were randomly allocated into two groups: the ESPB group (n = 20) and the control group (n = 20). All patients received preoperatively ultrasound-guided, bilateral ESPB with placement of catheters for continuous infusion. Patients in the ESPB group received 0.375% ropivacaine, while patients in the control group received sham blocks. All patients received standardized general anesthesia and multimodal postoperative analgesia. Pain scores, perioperative opioid consumption, and perioperative outcomes were assessed. Patients in the ESPB group required significantly less intraoperative (p < 0.001 for open colectomies, p = 0.002 for laparoscopic colectomies) and postoperative opioids (p < 0.001 for open colectomies, p = 0.002 for laparoscopic colectomies) and had higher quality of recovery scores on the third postoperative day (p = 0.002 for open and laparoscopic colectomies). Patients in the ESPB group did not exhibit lower postoperative pain scores compared to those in the control group (p > 0.05 at various time points), while patients in both groups reported comparable satisfaction scores with their perioperative pain management (p = 0.061 for open colectomies, and p = 0.078 in laparoscopic colectomies). No complications were reported. ESPB is a novel and effective strategy in reducing perioperative opioid consumption in patients undergoing colectomy. This technique, as part of a multimodal analgesic plan and enhanced recovery after surgery protocols, can be proven valuable in improving the comfort and satisfaction of patients undergoing colorectal surgery.

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