Doyeon Kim1, Jong Man Kim, Gyu-Seong Choi, Gunyoung Heo, Gaab Soo Kim, Ji Seon Jeong. 1. From the Department of Anesthesiology and Pain Medicine (DK, GH, GSK, JSJ) and Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (JMK, G-SC).
Abstract
BACKGROUND:Erector spinae plane block (ESPB) has been reported to manage postoperative pain effectively after various types of surgery. However, there has been a lack of study on the effect of ESPB after liver resection. OBJECTIVES: To investigate the analgesic effects of ESPB on pain control after laparoscopic liver resection compared with conventional pain management. DESIGN: Prospective, randomised controlled study. SETTING:A single tertiary care centre from February 2019 to February 2020. PATIENTS: A total of 70 patients scheduled to undergo laparoscopic liver resection. INTERVENTIONS: In the control group (n = 35), no procedure was performed. In the ESPB group (n = 35), ESPB was performed after induction of general anaesthesia. A total of 40 ml of ropivacaine 0.5% was injected at the T9 level bilaterally. After surgery, intravenous fentanyl patient-controlled analgesia was initiated. Fentanyl and hydromorphone were administered as rescue analgesics. MAIN OUTCOME MEASURES: The primary outcome was the cumulative postoperative opioid consumption at 24 h (morphine equivalent). The secondary outcomes were rescue opioid (fentanyl) dose in the postanaesthesia care unit (PACU) and pain severity at 1, 6, 12, 24, 48 and 72 h, assessed using a numerical rating scale (NRS) score. RESULTS: The median [IQR] postoperative opioid consumption during 24 hours following surgery was 48.2 [17.1] mg in the control group and 45.5 [35.8] mg in the ESPB group (median difference, 4.2 mg; 95% CI, -4.2 to 13.3 mg; P = 0.259). Conversely, rescue opioid in PACU was 5.3 [5.0] mg in the control group and 3.0 [1.5] mg in the ESPB group (median difference, 2.5 mg; 95% CI, 1.0 to 5.0 mg; P < 0.001). There was no significant difference in NRS scores point between the groups at any time. CONCLUSION:ESPB does not provide analgesic effect within 24 h after laparoscopic liver resection. TRIAL REGISTRATION: Clinical Trial Registry of Korea (https://cris.nih.go.kr.), identifier: KCT0003549).
RCT Entities:
BACKGROUND: Erector spinae plane block (ESPB) has been reported to manage postoperative pain effectively after various types of surgery. However, there has been a lack of study on the effect of ESPB after liver resection. OBJECTIVES: To investigate the analgesic effects of ESPB on pain control after laparoscopic liver resection compared with conventional pain management. DESIGN: Prospective, randomised controlled study. SETTING: A single tertiary care centre from February 2019 to February 2020. PATIENTS: A total of 70 patients scheduled to undergo laparoscopic liver resection. INTERVENTIONS: In the control group (n = 35), no procedure was performed. In the ESPB group (n = 35), ESPB was performed after induction of general anaesthesia. A total of 40 ml of ropivacaine 0.5% was injected at the T9 level bilaterally. After surgery, intravenous fentanylpatient-controlled analgesia was initiated. Fentanyl and hydromorphone were administered as rescue analgesics. MAIN OUTCOME MEASURES: The primary outcome was the cumulative postoperative opioid consumption at 24 h (morphine equivalent). The secondary outcomes were rescue opioid (fentanyl) dose in the postanaesthesia care unit (PACU) and pain severity at 1, 6, 12, 24, 48 and 72 h, assessed using a numerical rating scale (NRS) score. RESULTS: The median [IQR] postoperative opioid consumption during 24 hours following surgery was 48.2 [17.1] mg in the control group and 45.5 [35.8] mg in the ESPB group (median difference, 4.2 mg; 95% CI, -4.2 to 13.3 mg; P = 0.259). Conversely, rescue opioid in PACU was 5.3 [5.0] mg in the control group and 3.0 [1.5] mg in the ESPB group (median difference, 2.5 mg; 95% CI, 1.0 to 5.0 mg; P < 0.001). There was no significant difference in NRS scores point between the groups at any time. CONCLUSION:ESPB does not provide analgesic effect within 24 h after laparoscopic liver resection. TRIAL REGISTRATION: Clinical Trial Registry of Korea (https://cris.nih.go.kr.), identifier: KCT0003549).
Authors: RyungA Kang; Seungwon Lee; Gaab Soo Kim; Ji Seon Jeong; Mi Sook Gwak; Jong Man Kim; Gyu-Seong Choi; Yoon Jee Cho; Justin Sangwook Ko Journal: J Pain Res Date: 2021-12-11 Impact factor: 3.133
Authors: Jesse W Stewart; Adam Yopp; Matthew R Porembka; John D Karalis; Mary Sunna; Cedar Schulz; John C Alexander; Irina Gasanova; Girish P Joshi Journal: Cureus Date: 2022-08-19