The effect of ultrasound-guided erector spinae plane block in postoperative analgesia of patients undergoing abdominal surgery
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DISEASE(S): Liver Cancer And Colorectal Cancer
PROVIDER: 2681981 | ecrin-mdr-crc |
REPOSITORIES: ECRIN MDR
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Project description:Regional anesthesia and pain management have experienced advances in recent years, especially with the advent of fascial plane blocks. The erector spinae plane block is one of the newest techniques to be described. In the past two years, publications referring to ESP block have increased significantly. The objective of this review is to analyze the articles about ESP block that have been published to date. We performed a search in the main databases and identified 368 articles. After a selection of the relevant articles, 125 studies were found eligible and were included in the review. The ESP block is performed by depositing the local anesthetic in the fascial plane, deeper than the erector spinae muscle at the tip of the transverse process of the vertebra. Many cases of its use have been described with satisfactory results in the treatment of both acute pain and chronic pain. The applicability of the technique covers many clinical scenarios. Of the 98 case reports reviewed, 12 and 87 articles, respectively described the technique as a treatment for chronic pain and acute pain. The single-shot was the most frequently used technique. As described in the articles published to date, the technique is easy to perform and has a low rate of complications. However, despite the effectiveness of the technique, further studies are necessary to obtain more evidence of its actions.
| S-EPMC6547235 | biostudies-literature
Project description: Not available
| S-EPMC9998304 | biostudies-literature
Project description:Abstract Defined in the last decade, erector spinae plane block (ESPB) is one of the more frequently used interfacial plans, and it has been the most discussed block among the recently defined techniques. Lumbar ESPB administered at lumbar levels is relatively novel and is a new horizon for regional anesthesia and pain practice. In this article, we aim to explain and introduce different approaches and explain the possible mechanism of action of lumbar ESPB. The objective of this review is to analyze the case reports, clinical and cadaveric studies about lumbar ESPB that have been published to date. We performed a search in “Pubmed” and “Google Scholar” database. After a selection of the relevant studies, 59 articles were found eligible and were included in this review. While we believe that lumbar ESPB is reliable and easy, we suggest that its efficacy and indications should be verified with anatomical and clinical studies, and its safety should be confirmed with pharmacokinetic studies. Moreover, the possibility of complications must be considered.
| S-EPMC7532310 | biostudies-literature
Project description:Interventions: Patient-controlled intravenous analgesia group (PCIA group):Intravenous analgesia was used. The analgesic formula was sufentanil 200ug+ Ondansetron 8mg, with a total capacity of 100ml;Ultrasound-guided transabdominal muscle plane block with high concentration group (TAP5 group):An ultrasound-guided transversal plane block was performed on both sides, with each side injected with 0.5% ropivacaine (AstraZeneca, UK) 15ml;Ultrasound-guided erector spinae plane blcok with high concentration group (ESPB5 group):An ultrasound-guided vertical spinal muscle plane block was performed on both sides, each side was injected with 0.5% ropivacaine (AstraZeneca, UK) 15ml;High concentration group of epidural block analgesia (EB5 group):An epidural puncture was performed between T7-T8 and an injection of 0.5% ropivacaine (AstraZeneca, UK) 7ml was performed;Ultrasound-guided transabdominal muscle plane block with low concentration group (TAP3 group):An ultrasound-guided transversal plane block was performed on both sides, and 0.3% ropivacaine (AstraZeneca, UK) 15ml was injected on each side;Ultrasound-guided erector spinae plane block with low concentration group (ESPB3 group):An ultrasound-guided erector spinae plane block was performed on both sides, with each side at the T8 transverse process level. And 0.3% ropivacaine (AstraZeneca, UK) was injected with 15ml;Epidural block analgesia with low concentration group (EB3 group):The epidural puncture was performed between T8-T9 and injected with 0.3% ropivacaine (AstraZeneca, UK) 7ml;Combined with dexmedetomidine for ultrasound-guided transabdominal muscle plane block group (TAPDEX group):An ultrasound-guided transversal muscle plane block was performed on both sides, with 0.5% ropivacaine (AstraZeneca, UK) and 15ml of dexmedetomidine mixe
Primary outcome(s): Postoperative pain intensity score;Indicators related to inflammatory response;Indicators related to immune function
Study Design: Parallel
| 2696553 | ecrin-mdr-crc
Project description:Multimodal anesthesia, which combines general and epidural anesthesia, is used in surgical cases in which a large or painful incision is anticipated. However, both epidural blocks and opioid-based analgesia have limitations in application. Here, we present a case of supra-infraumbilical laparotomy in a patient whose history of neurostimulator use and marked scoliosis discouraged the placement of an epidural catheter and whose prior adverse response to opioids prohibited their use. The intraoperative and postoperative management of this patient consisted of a combination of analgesia without opioids and erector spinae plane block. Adequate analgesia was achieved, and intraoperative or postoperative opioids were not required. This case illustrates the importance of mastering alternative and multimodal analgesia techniques that can be used in place of classical analgesia techniques when classical analgesia techniques are not appropriate.
| S-EPMC7140130 | biostudies-literature
Project description:Surgical repair of the hip is considered an extremely painful procedure. Managing pain in this surgery is challenging even with several available options, each with limitations. Erector spinae plane (ESP) block is a novel technique that has been used in different types of surgery, with promising results. Herein, we describe a case of a successful ESP block for pediatric hip surgery. In the future, ESP block could be an alternative technique for providing effective analgesia.
| S-EPMC6369335 | biostudies-literature
Project description: Not available
| S-EPMC8568357 | biostudies-literature
Project description:BackgroundAlthough the erector spinae plane block has been used in various truncal surgical procedures, its clinical benefits in patients undergoing spinal surgery remain controversial. The aim of this meta-analysis was to evaluate the clinical benefits of erector spinae plane block in patients undergoing spinal surgery.MethodsWe searched the Cochrane Library, PubMed, EMBASE, and China National Knowledge Infrastructure for randomized controlled trials comparing the erector spinae plane block with a nonblocked control for spinal surgery.ResultsTwelve studies encompassing 696 subjects were included in our systematic review and meta-analysis. We found that the erector spinae plane block decreased postoperative pain scores and opioid consumption in the postoperative and intraoperative periods. Moreover, it prolonged the time to the first rescue analgesic, reduced the number of patients who required rescue analgesia, and lowered the incidence of postoperative nausea and vomiting. However, it did not exhibit efficacy in decreasing the incidence of urinary retention and itching or shortening the length of hospital stays, or the time to first ambulation.ConclusionsErector spinae plane block improves analgesic efficacy among patients undergoing spinal surgery compared with nonblocked controls; however, there is insufficient evidence regarding the benefits of erector spinae plane block for rapid recovery.
| S-EPMC8494958 | biostudies-literature
Project description:PurposeErector spinae plane (ESP) block is an interfascial blockade used in different clinical scenarios. This study investigated the ventral extent of dye diffusion in ESP block.MethodsThe ultrasound-guided ESP block was bilaterally performed with an injection at the T5 vertebral level (21-Gauge, 50 mm needle), using diluted black tissue marking dye (20 mL; 1:4 ratio with standard saline solution) instead of local anesthetic on two fresh-frozen corpses within the body donation program of the University of Padova. Subsequently, the gross anatomical dissection was performed by a combined posterior plus anterior approach, and the histotopographic examination completed.ResultsMacroscopically by gross anatomical dissection, the dye spreading ranged on the dorsal side of the chest from T2/3 to T10/11 with an extension up to 10 cm laterally, and on the ventral side of the chest from T2/3-T9/10. Microscopically by histotopographic examination, the dye diffused ventrally to the intercostal spaces (2-3 and 5-6 spaces on the right and left, respectively) by following the blood vessels coupled to the dorsal nerve passing through the costotransverse foramen.ConclusionsThe anterior pathway of dye diffusion from the site of injection within the erector spinae muscle group during an ESP block seems to follow the blood vessels and dorsal rami of spinal nerves, suggesting the passing through the costotransverse foramen to reach the anterior paravertebral space and the intercostal nerves. These findings display an anterior histotopographic diffusion of dye resembling a paravertebral block.
| S-EPMC7840626 | biostudies-literature
Project description:Erector spinae plane (ESP) blocks are a regional anaesthetic technique used for pain relief in thoracic procedures. Our centre has recently begun using ESP blocks pre-medical thoracoscopy for analgesia. Nine patients undergoing MT from September 2021 to February 2022 were included. Opioid use and depth of required sedation was recorded. Pre and post pain scores and at home were recorded by interview and review of charts. A functional pain questionnaire was administered via telephone. Average greatest depth of sedation using propofol was 1.92 (standard error of mean [SEM] 0.27), with remifentanil 2.52 (SEM 0.46). 78% required oral analgesia on day 0 post discharge. 55% required oral analgesia on post-op day 1. Patients used an average of 3.33 mg oral morphine (SEM 2.35) in hospital, and 3 mg (SEM 2) on post-op day 1. Periprocedural pain scores were 0.66 (SEM 0.27). Pain scores in recovery were 1.56 (SEM 0.76). Pain scores 3-12 h post discharge were 3.56 (SEM 0.7), while pain scores on post-op day 1 were significantly higher at 5.56 (SEM 0.90) (Figure 1). Functional pain scoring showed patients doing activities of daily living well with a good ability to breathe and cough. All felt that their pain was well controlled on the day of the procedure and at home. No complications were reported. ESP blocks provide good analgesia. Pain scores showed significant analgesic effect lasting several hours. The project showed pain outcomes and patient acceptability were good for the use of regional anaesthesia.
| S-EPMC9742453 | biostudies-literature