Yusheng Yao1, Shiwei Fu2, Shuangbo Dai1, Jia Yun3, Minghui Zeng1, Hao Li1, Xiaochun Zheng4. 1. Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China. 2. Department of Pathology, Union Hospital of Fujian Medical University, Fuzhou, Fujian, China. 3. The 95th Clinical Department, The 900th Hospital of Joint Service Support Force of the PLA, Putian, China. 4. Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China; Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou, China. Electronic address: fjslyys@mail.fjmu.edu.cn.
Abstract
STUDY OBJECTIVE:Regional anesthesia improves postoperative analgesia and enhances the quality of recovery (QoR) after surgery. We examine the efficacy of ultrasound-guided erector spinae plane block (ESPB) on QoR after video-assisted thoracic surgery (VATS). DESIGN: Prospective, randomized, double-blinded, placebo-controlled trial. SETTING: Single institution, tertiary university hospital. PATIENTS: Adult patients who scheduled for VATS under general anesthesia were enrolled in the study. INTERVENTIONS: We randomly allocated patients to receive preoperative ultrasound-guided ESPB with 25 ml of either 0.5% ropivacaine (ESPB group) or normal saline (Control group). MEASUREMENTS: The primary outcome was QoR as measured by the 40-item QoR questionnaire (QoR-40) score at postoperative day 1. Secondary results were post-anesthesia care unit (PACU) discharge time, acute postoperative pain, cumulative opioid consumption, the incidence of postoperative nausea or vomiting (PONV), and patient satisfaction. MAIN RESULTS: The global QoR-40 score at postoperative day 1 (median, interquartile range) was significantly higher in the ESPB group (174, 170 to 177) than the control group (161.5, 160 to 165), estimated median difference 11 (95% CI 9 to 13, P < 0.001). Compared with the control group, single-injection of ESPB reduced PACU discharge time, acute postoperative pain, and cumulative opioid consumption. Correspondingly, the median patient satisfaction scores were higher in the ESPB group than the control group (9 versus 7, P < 0.001). CONCLUSION: Preoperative single-injection thoracic ESPB with ropivacaine improves QoR, postoperative analgesia, and patient satisfaction after VATS.
RCT Entities:
STUDY OBJECTIVE: Regional anesthesia improves postoperative analgesia and enhances the quality of recovery (QoR) after surgery. We examine the efficacy of ultrasound-guided erector spinae plane block (ESPB) on QoR after video-assisted thoracic surgery (VATS). DESIGN: Prospective, randomized, double-blinded, placebo-controlled trial. SETTING: Single institution, tertiary university hospital. PATIENTS: Adult patients who scheduled for VATS under general anesthesia were enrolled in the study. INTERVENTIONS: We randomly allocated patients to receive preoperative ultrasound-guided ESPB with 25 ml of either 0.5% ropivacaine (ESPB group) or normal saline (Control group). MEASUREMENTS: The primary outcome was QoR as measured by the 40-item QoR questionnaire (QoR-40) score at postoperative day 1. Secondary results were post-anesthesia care unit (PACU) discharge time, acute postoperative pain, cumulative opioid consumption, the incidence of postoperative nausea or vomiting (PONV), and patient satisfaction. MAIN RESULTS: The global QoR-40 score at postoperative day 1 (median, interquartile range) was significantly higher in the ESPB group (174, 170 to 177) than the control group (161.5, 160 to 165), estimated median difference 11 (95% CI 9 to 13, P < 0.001). Compared with the control group, single-injection of ESPB reduced PACU discharge time, acute postoperative pain, and cumulative opioid consumption. Correspondingly, the median patient satisfaction scores were higher in the ESPB group than the control group (9 versus 7, P < 0.001). CONCLUSION: Preoperative single-injection thoracic ESPB with ropivacaine improves QoR, postoperative analgesia, and patient satisfaction after VATS.
Authors: Muhammad Zubair; Muhammad Adil Khan; Muhammad Nasir Ayub Khan; Sajida Iqbal; Muhammad Ashraf; Salman A Saleem Journal: Cureus Date: 2022-03-14