Postoperative recovery with continuous erector spinae plane block or video-assisted paravertebral block after minimally invasive thoracic surgery: a prospective, randomised controlled trial

Moorthy, Aneurin; Eochagáin, Aisling Ní; Dempsey, Eamon; Wall, Vincent; Marsh, Hannah; Murphy, T.K.; Fitzmaurice, Gerard J.; Naughton, Rory A.; Buggy, Donal J.

doi:10.1016/j.bja.2022.07.051

Cited by 23 publications

(17 citation statements)

References 43 publications

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“…Compared with the QLB group,the QoR-15 score varied significantly after surgery at 24h in the ESPB group,and this result was also confirmed in the randomized controlled study of Moorthy et al [27] .In this study, ESPB and paravertebral block (PVB) were performed after chest surgery and inserted for continuous local anesthetic infusion, QoR-15 score was significantly higher in ESPB patients. Another study showed [28] preoperative QLB in open gastrointestinal surgery, could improve the QoR-15 score at 48 hours and improve the early postoperative analgesia.The higher QoR-15 score after ESPB, we speculate, may be related to the lower postoperative pain score.…”

Section: Disscussionsupporting

confidence: 79%

Comparison of ultrasound-guided erector spinal muscle plane block and quadratus block for laparoscopic renal cancer resection:A single-center,double-blind, randomized controlled trial

Zhang,

Zhao,

et al. 2024

Preprint

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Objective:This study investigated the effects of ultrasound-guided erector spinal muscle plane block (ESPB) and quadratus muscle block (QLB) on the quality of analgesia and recovery after laparoscopic nephrectomy.Design:randomized, controlled, double-blind study.Setting: A single tertiary care academic medical center,include anesthesia preparation room, operating room, anesthesia recovery room and ward.Patients:Aged 18-70years,ASA grades I-III,elective laparoscopic partial nephrectomy or radical nephrectomy and 54 patients were included in the statistical analysis.Interventions:All included patients were randomassigned to the erector spinal muscle plane block or the quadratus block,and all patients underwent morphine pump controlled analgesia.Results:The study found that ultrasound-guided ESPB had a higher incidence of hypotension than QLB at the T1 time point, but it did not significantly increase the intraoperative dose of the vasoactive drug used. Patients in the ESPB group showed significant improvement in resting NRS pain scores at 0.5h,number of morphine pumps at 6h and 24h, cumulative morphine equivalent consumed 6h after surgery, and QOR-15 score at 24 h after surgery, and shortened hospital stay.Conclusions:Compared with QLB,ESPB has certain advantages in analgesia and recovery quality after laparoscopic nephrectomy, and shows opioid frugality effect at individual postoperative time points.

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Section: Disscussionsupporting

confidence: 79%

Comparison of ultrasound-guided erector spinal muscle plane block and quadratus block for laparoscopic renal cancer resection:A single-center,double-blind, randomized controlled trial

Zhang,

Zhao,

et al. 2024

Preprint

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“…These authors showed an improvement in the Quality of Recovery score-15 (QoR-15) favoring the ESPB [27]. The main differences were in general well being and sleeping/ resting which may be prone for bias depending on the surgical precondition [27]. However, no differences in pain scores, opioid consumption, hospital LOS, or complications were identified [27].…”

Section: The Surgeon the Forgotten Partnermentioning

confidence: 97%

“…The main differences were in general well being and sleeping/ resting which may be prone for bias depending on the surgical precondition [27]. However, no differences in pain scores, opioid consumption, hospital LOS, or complications were identified [27]. Because currently no further evidence is available, a definitive conclusion on the advantage of ESPB over surgical PVB cannot be reached.…”

Section: The Surgeon the Forgotten Partnermentioning

confidence: 97%

“…Moorthy et al [27] conducted the only randomized controlled trial, that we know of, comparing ESPB versus surgical PVB. These authors showed an improvement in the Quality of Recovery score-15 (QoR-15) favoring the ESPB [27]. The main differences were in general well being and sleeping/ resting which may be prone for bias depending on the surgical precondition [27].…”

Section: The Surgeon the Forgotten Partnermentioning

confidence: 99%

“…In contrast, the ESPB is often proposed as a simple block, even for nonregional specialist. Moorthy et al [27] conducted the only randomized controlled trial, that we know of, comparing ESPB versus surgical PVB. These authors showed an improvement in the Quality of Recovery score-15 (QoR-15) favoring the ESPB [27].…”

Section: The Surgeon the Forgotten Partnermentioning

confidence: 99%

See 2 more Smart Citations

Get your 7-point golden medal for pain management in video-assisted thoracoscopic surgery

Hoogma,

Brullot,

Coppens

2023

Current Opinion in Anaesthesiology

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Purpose of review Thoracic surgery is evolving, necessitating an adaptation for perioperative anesthesia and analgesia. This review highlights the recent advancements in perioperative (multimodal) analgesia for minimally invasive thoracic surgery. Recent findings Continuous advancements in surgical techniques have led to a reduction in surgical trauma. However, managing perioperative pain remains a major challenge, impeding postoperative recovery. The traditional neuraxial technique is now deemed outdated for minimally invasive thoracic surgery. Instead, newer regional techniques have emerged, and traditional approaches have undergone (re-)evaluation by experts and professional societies to establish guidelines and practices. Assessing the quality of recovery, even after discharge, has become a crucial factor in evaluating the effectiveness of these strategies, aiding clinicians in making informed decisions to improve perioperative care. Summary In the realm of minimally invasive thoracic surgery, perioperative analgesia is typically administered through systemic and regional techniques. Nevertheless, collaboration between anesthesiologists and surgeons, utilizing surgically placed nerve blocks and an active chest drain management, has the potential to significantly improve overall patient care.

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Ultrasound-guided erector spinae plane block improves analgesia after laparoscopic hepatectomy. Comment on Br J Anaesth 2022; 129: 445–53

Zhang

Niu

Miao

et al. 2023

British Journal of Anaesthesia

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Postoperative recovery with continuous erector spinae plane block or video-assisted paravertebral block after minimally invasive thoracic surgery: a prospective, randomised controlled trial

Cited by 23 publications

References 43 publications

Comparison of ultrasound-guided erector spinal muscle plane block and quadratus block for laparoscopic renal cancer resection:A single-center,double-blind, randomized controlled trial

Comparison of ultrasound-guided erector spinal muscle plane block and quadratus block for laparoscopic renal cancer resection:A single-center,double-blind, randomized controlled trial

Get your 7-point golden medal for pain management in video-assisted thoracoscopic surgery

Ultrasound-guided erector spinae plane block improves analgesia after laparoscopic hepatectomy. Comment on Br J Anaesth 2022; 129: 445–53

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