Use of Erector Spinae Plane Block in Thoracic Surgery Leads to Rapid Recovery From Anesthesia

Chaudhary, Omar; Baribeau, Yanick; Urits, Ivan; Sharkey, Aidan; Rashid, Rayan; Hess, Philip E.; Krumm, Santiago; Fatima, Huma; Zhang, Qianqian; Gangadharan, Sidhu P.; Mahmood, Feroze; Matyal, Robina

doi:10.1016/j.athoracsur.2020.03.117

“…A previous study reported that ESPB can provide superior quality of recovery at 24 h, better analgesia, and lower morbidity after minimally invasive thoracic surgery [ 27 ]. Another recent study also revealed that as a part of multimodal analgesia, ESPB has a potential for enhanced recovery from VATS [ 29 ]. For a more accurate evaluation of patient recovery, baseline QoR-15 values were collected for all enrolled patients.…”

Section: Discussionmentioning

confidence: 99%

The effects of erector spinae plane block on perioperative opioid consumption and rehabilitation in video assisted thoracic surgery

Zhang

¹

,

Han

²

,

Zhou

³

et al. 2021

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Background This study aimed to determine whether ultrasound-guided continuous erector spinae plane block (ESPB) had an effect on opioid consumption and postoperative rehabilitation in patients undergoing video-assisted thoracic surgery (VATS). Methods In this prospective study, 120 patients aged 20–70 years who underwent elective VATS were randomly allocated to one of three groups: group C (general anesthesia with patient-controlled intravenous analgesia [PCIA]), group T (general anesthesia with patient-controlled epidural analgesia [PCEA]), or group E (general anesthesia with continuous ESPB and PCIA). Perioperative opioid consumption, visual analog scale (VAS) scores, preoperative and postoperative Quality of Recovery-15 scores, and postoperative opioid-related adverse events were all assessed. Results Intraoperative sufentanil consumption in groups T and E was significantly lower than that in group C (both P < 0.001), and the postoperative sufentanil consumption in group E was also significantly lower than that in group C (P = 0.001). Compared with group C, the VAS scores at rest or during coughing immediately out of the post-anesthesia care unit at 6 h, 12 h, and 24 h postoperatively were significantly lower in group T (P < 0.05). However, the VAS scores at rest at 6 h and 12 h postoperatively in group E were lower than those of group C (P < 0.05), but were significantly higher than those of group T at all study times (P < 0.05). Conclusion Ultrasound-guided continuous ESPB significantly reduced perioperative opioid consumption during VATS and improved postoperative rehabilitation. However, these effects were inferior to those of thoracic epidural anesthesia. Trial registration The present study was prospectively registered at http://www.chictr.org/cn /(registration number: ChiCTR1900023050); registration date: May 82,019.

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“…In this case series, we describe 3 patients with adolescent idiopathic scoliosis who received either continuous erector spinae plane block (ESPB) catheters or intercostal nerve block (ICNB) with liposomal bupivacaine (Exparel; Pacira BioSciences, Inc) for postoperative pain management after bilateral VBT via the minithoracotomy approach. An ESPB is a truncal regional block that has been [shown to be] an effective analgesic adjunct in thoracic, 3,4 lumbar spine, 5 and abdominal 6,7 surgeries. ICNBs are well recognized to block sensory innervation to the chest, abdomen, and back.…”

Section: Glossarymentioning

confidence: 99%

Regional Anesthetic Approaches for Postoperative Analgesia Following Vertebral Body Tethering: A Case Series

Lee

¹

,

Kydes

²

2021

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Vertebral body tethering (VBT) is an innovative surgical technique used to treat juvenile and adolescent idiopathic scoliosis. The optimal anesthetic technique, including the preferred management of postoperative pain, is not known. In this case series, we describe 3 patients with adolescent idiopathic scoliosis who received either continuous erector spinae plane block (ESPB) catheters or intercostal liposomal bupivacaine for postoperative pain management after bilateral VBT via minithoracotomy. (A&A Practice. 2021;15:e01510.

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“…Currently, several regional nerve blocks are used for analgesia after thoracic surgery, such as serratus plane block (SAB), erector spinae plane block (ESP), and rhomboid intercostal block (RIB). However, their analgesic effects vary in strength, and the question of which technique is safer and more effective is still controversial [7][8][9][10]. Further clinical studies are needed to answer this.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Rhomboid Intercostal Block, Erector Spinae Plane Block, and Serratus Plane Block on Analgesia for Video-Assisted Thoracic Surgery: A Prospective, Randomized, Controlled Trial

Zhang

¹

,

Jiang

²

,

Deng

³

et al. 2022

International Journal of Clinical Practice

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Background. Thoracic surgery is one of the most painful surgical steps. An important tool for managing postoperative pain is effective postoperative analgesia. This research aimed at comparing the analgesic roles of three new fascial block techniques in the postoperative period after video-helped thoracoscopic operation (VATS). Methods. We randomly allocated ninety patients into three teams experiencing ultrasound-directed serratus plane block, erector spinae plane block, and the rhomboid intercostal block, respectively. 0.4% ropivacaine of 20 mL was received by all groups. Outcomes. At 0–12 hours, sufentanil consumption was significantly lower in the RIB (35.2 ± 3.3 mg) and ESP (35.4 ± 2.8 mg) groups than that in the SAB (43.3 ± 2.7 mg) group P < 0.001 , and no obvious diversity in sufentanil consumption was shown between the RIB and ESP groups P = 0.813 . At 12–24 hours, sufentanil consumption was greatly lower in the RIB and ESP groups than that in the SAB group P < 0.001 , and no great diversity in sufentanil consumption was found between the RIB and ESP groups P = 0.589 . No great diversity in sufentanil consumption was shown between the RIB (50.4 ± 1.4 mg), ESP (50.4 ± 1.5 mg), and SAB (51.0 ± 1.7 mg) groups at 24–48 hours P = 0.192 . At 6, 12, 18, and 24 hours, the postoperative dynamic NRS scores were significantly lower in the RIB and ESP groups than in the SAB group ( P < 0.05 for all contrasts). Nevertheless, no great diversity was observed in postoperative pain marks at 0.5, 1, 3, 6, 12, 18, 24, 36, and 48 hours after the surgery across the three groups. No statistical diversity was found in the postoperative NRS mark between groups RIB and ESP within 48 hours after surgery in case of active patients ( P < 0.05 for all contrasts). At 24 hours after surgery, a significant difference in IL-1β and IL-6 inflammatory factor concentrations was found between RIB and ESP compared with SAB block ( P < 0.05 for all contrasts). However, no great diversities were observed in IL-1β, and IL-6 inflammatory factor concentrations between RIB, ESP, and SAB at 24 hours preoperatively and at 48 hours postoperatively ( P < 0.05 for all comparisons). Conclusion. The dosage of sufentanil can be effectively reduced by ultrasound-directed rhomboid intercostal block and erector spinae plane block within 24 hours after VATS surgery, and pain can be relieved effectively within 24 hours by comparing with serratus plane block.

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Use of Erector Spinae Plane Block in Thoracic Surgery Leads to Rapid Recovery From Anesthesia

Cited by 25 publications

References 18 publications

The effects of erector spinae plane block on perioperative opioid consumption and rehabilitation in video assisted thoracic surgery

The effects of erector spinae plane block on perioperative opioid consumption and rehabilitation in video assisted thoracic surgery

Regional Anesthetic Approaches for Postoperative Analgesia Following Vertebral Body Tethering: A Case Series

Comparison of Rhomboid Intercostal Block, Erector Spinae Plane Block, and Serratus Plane Block on Analgesia for Video-Assisted Thoracic Surgery: A Prospective, Randomized, Controlled Trial

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