Ultrasound-guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy: Randomized, controlled trial

Altıparmak, Başak; Toker, Melike Korkmaz; Uysal, Ali İhsan; Kuşçu, Yağmur; Demirbilek, Semra

doi:10.1016/j.jclinane.2019.03.012

Cited by 106 publications

(83 citation statements)

References 22 publications

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“…The reason for the exclusion was as shown below: case report (n = 1), conference abstract (n = 1). Therefore, a total of 8 RCTs with 442 patients were included in the final analysis ( Figure 1 ) [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ] 199 patients were allocated to the ESPB group, 168 patients were allocated to the control group, and 75 patients were allocated to the oblique subcostal transversus abdominis plane (OSTAP) block group. Some studies have multiple groups [ 19 , 23 ].…”

Section: Resultsmentioning

confidence: 99%

The Effects of Erector Spinae Plane Block in Terms of Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy: A Meta-Analysis of Randomized Controlled Trials

Koo

Hwang

Shin

et al. 2020

JCM

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Ultrasound-guided erector spinae plane block (ESPB), a recent regional analgesic technique, has been used to manage acute pain after surgery. The aim of this meta-analysis is to identify the benefits of ESPB in patients undergoing laparoscopic cholecystectomy (LC). The authors searched PubMed, EMBASE, CENTRAL, CINAHL, and Web of Science to identify all randomized controlled trials (RCTs) evaluating the effects of ESPB on postoperative pain after LC. Primary outcome was defined as 24 h cumulative opioid consumption. Secondary outcomes were pain scores and the incidence of postoperative nausea and vomiting (PONV). We estimated mean differences (MD) and odds ratio (OR) using a random-effects model. A total of 8 RCTs, including 442 patients, were included in the final analysis. Postoperative opioid consumption was significantly lower in the ESPB group than in the control group (MD −4.72, 95% CI −6.00 to −3.44, p < 0.001). Compared with the control group, the ESPB group also showed significantly lower pain scores and incidence of PONV. A separate analysis of RCTs comparing ESPB with oblique subcostal transversus abdominis plane (OSTAP) block showed that the analgesic efficacy of ESPB was similar to that of OSTAP block. The results of this meta-analysis demonstrated that ESPB may provide effective postoperative analgesia in patients undergoing LC.

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Section: Resultsmentioning

confidence: 99%

The Effects of Erector Spinae Plane Block in Terms of Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy: A Meta-Analysis of Randomized Controlled Trials

Koo

Hwang

Shin

et al. 2020

JCM

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“…Last, compared to other regional block techniques such as transversus abdominis plane block (TAPB), serratus plane block (SPB), and Quadratus Lumborum Block (QLB), is the erector spine block more effective in some operations where the block areas overlap? Several RCTs on these topics published recently but far from achieving convincing conclusions [40][41][42].…”

Section: Implications For Clinical Researchesmentioning

confidence: 99%

Ultrasound-guided erector spinae plane block for postoperative analgesia: a meta-analysis of randomized controlled trials

Huang

Liu

2020

BMC Anesthesiol

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Background: Ultrasound-guided Erector Spinae Plane Block (ESPB) has been increasingly applied in patients for postoperative analgesia. Its effectiveness remain uncertain. This meta-analysis aimed to determine the clinical efficacy of ultrasound-guided ESPB in adults undergoing general anesthesia (GA) surgeries. Methods: A systematic databases search was conducted in PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) comparing ESPB with control or placebo. Primary outcome was iv. opioid consumption 24 h after surgery. Standardized mean differences (SMDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated with a random-effects model. Results: A total of 12 RCTs consisting of 590 patients were included. Ultrasound-guided ESPB showed a reduction of intravenous opioid consumption 24 h after surgery (SMD = − 2.18; 95% confidence interval (CI)-2.76 to − 1.61,p < 0.00001). Considerable heterogeneity was observed (87%). It further reduced the number of patients who required postoperative analgesia (RR = 0.41,95% CI 0.25 to 0.66,p = 0,0002) and prolonged time to first rescue analgesia (SMD = 4.56,95% CI 1.89 to 7.22, p = 0.0008). Conclusions: Ultrasound-guided ESPB provides effective postoperative analgesic in adults undergoing GA surgeries.

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“…They also thought that the dermatomal extension of the local anesthetic in the ESPB block is greater than the OS-TAP block. [6] Because ESPB block is targeted to ventral, dorsal ramie and ramie communicators of spinal nerves. On the other hand, OSTAP block affects somatic and parietal components of postoperative pain and has no effect on visceral component.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, OSTAP block affects somatic and parietal components of postoperative pain and has no effect on visceral component. [6,7]…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Ultrasound-Guided Bilateral Erector Spinae Plane Block for Pediatric Laparoscopic Cholecystectomy: Case Series

Karaca

Pınar

2019

Agri

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ÖzetAmeliyat sonrası opioid uygulaması uyku hali ve solunum sıkıntısı, bulantı ve kusma gibi çeşitli yan etkilere neden olabilir. Multimodal analjezinin bir parçası olarak opioid olmayan ilaçlar, akut cerrahi sonrası ağrının tedavisinde giderek artan ölçüde öne sürülmektedir. Bölgesel bir anestezi tekniği olan Erector spinae plan bloğu (ESPB) hem visseral hem de somatik sinir liflerini bloke eder. Pediatrik cerrahi olgularda çok az uygulaması olan laparoskopik kolesistekomide postoperatif ağrı için bir ESPB vaka serisi sunduk. Laparoskopik kolesistektomi yapılan dört hastaya ultrason eşliğinde bilateral ESPB yapıldı. Anestezi indüksiyonundan sonra, insizyon öncesi dönemde her iki taraftaki fasyalar arasındaki alanına% 0.25 bupivakain enjekte edildi. (toplam anestezi: 2.5 mg/kg) Ameliyat sonrası ağrı kontolü, her sekiz saatte bir 10 mg / kg'lık parasetamol ile planlandı. NRS (sayısal puanlama ölçeği) ağrı skorları, anestezi sonrası bakım ünitesinde (PACU) 1, 2, 4, 8, 12 ve 24. saatlerde üç puanın altındaydı. Kurtarma analjeziklerine (1 mg/kg tramadol) ihtiyaç olmadı. Bu yüzden, uyuşukluk, bulantı ve kusma gibi komplikasyonlar olmadı. Blokla ilişkili herhangi bir komplikasyonla karşılaşılmadı. Multimodal analjezi rejiminin bir parçası olan ESPB'un iki taraflı uygulanması, pediatrik laparoskopik kolesistektomi için postoperatif ilk 24 saatte etkili analjezi sağlamaktadır.Anahtar sözcükler: Erector spina blok; laparoskopik kolesistektomi; pediatri; postoperatif ağrı; ultrason. SummaryPostoperative opioid administration can cause various side effects, such as drowsiness, respiratory distress, postoperative nausea, and vomiting. The use of non-opioid medications as part of a multimodal analgesia method has been increasingly suggested in the management of acute postsurgical pain. Erector spinae plane block (ESPB), which is a regional anesthesia technique, blocks both visceral and somatic nerve fibers. Though it is infrequently used in young patients, presently described is a series of cases in which ESPB was successfully used in the performance of pediatric laparoscopic cholecystectomy. Ultrasound-guided bilateral ESPB was performed on 4 patients who underwent a laparoscopic cholecystectomy. An injection of 0.25% bupivacaine was administered into the interfascial area on each side in the pre-incisional period after the anesthesia induction (total anesthetic: 2.5 mg/kg). Postoperative pain control was planned at 10 mg/kg intravenous paracetamol every 8 hours. Numeric rating scale pain scores were less than 3 points in the post-anesthetic care unit, and at 1, 2, 4, 8, 12, and 24 hours. No rescue analgesic (1 mg/kg tramadol) was needed. None of the typical complications, such as drowsiness or nausea, were observed and no block-related complications were recorded. Bilateral ESPB that is a part of multimodal analgesia regimen can provide effective analgesia for pediatric laparoscopic cholecystectomy patients in the first 24 hours postoperatively.

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Ultrasound-guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy: Randomized, controlled trial

Cited by 106 publications

References 22 publications

The Effects of Erector Spinae Plane Block in Terms of Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy: A Meta-Analysis of Randomized Controlled Trials

The Effects of Erector Spinae Plane Block in Terms of Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy: A Meta-Analysis of Randomized Controlled Trials

Ultrasound-guided erector spinae plane block for postoperative analgesia: a meta-analysis of randomized controlled trials

Efficacy of Ultrasound-Guided Bilateral Erector Spinae Plane Block for Pediatric Laparoscopic Cholecystectomy: Case Series

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