Pain management for the Nuss procedure: comparison between erector spinae plane block, thoracic epidural, and control

作     者：Lisgelia Santana John Driggers Norman F Carvalho Lisgelia Santana;John Driggers;Norman F Carvalho

作者机构：Department of Anesthesiology and Pain ManagementNemours Children's HospitalOrlandoFloridaUSA AnesthesiologyUniversity of Central FloridaOrlandoFloridaUSA 

出 版 物：《World Journal of Pediatric Surgery》 (世界小儿外科杂志（英文）)

年 卷 期：2022年第5卷第4期

页      面：223-228页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：shorter ESP comparison 

摘      要：Objective Pectus excavatum is a congenital deformity characterized by a caved-in chest *** requires *** less invasive Nuss procedure is very successful,but postoperative pain management is challenging and *** pain management techniques to reduce opioid reliance include the erector spinae plane(ESP)*** retrospectively examined opioid consumption after Nuss procedure comparing three pain management techniques:ESP block,thoracic epidural(TE),and patient-controlled analgesia(PCA).Methods This retrospective cohort study compared pain management outcomes of three patient ***-eight subjects aged 10–18 years underwent Nuss procedure at our institution between January 2014 and January *** primary outcome measure was opioid consumption measured in morphine milligram *** measures included pain ratings and length of stay(LOS).Pain was quantified using the Numeric Pain Rating *** of variance was performed on all outcome *** Average cumulative opioid use was significantly lower in the ESP block(67 mg)than the TE(117 mg)(p=0.0002)or the PCA group(172 mg)(p=0.0002).The ESP block and PCA groups both had a significantly shorter average LOS(3.3 and 3.7 days,respectively)than the TE group(4.7 days).ESP block performed best for reducing opioid consumption and *** opioid consumption is key for limiting side *** study supports use of ESP block as a superior choice when choosing among the three postoperative pain management options that were *** ESP resulted in reduced opioid consumption postoperatively and shorter LOS than TE or PCA for patients undergoing the Nuss procedure for surgical repair of pectus excavatum.