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erector spinae plane block Combined with Serratus Anterior plane block Versus Thoracic Paravertebral block for Postoperative Analgesia and Recovery After Thoracoscopic Surgery:A Randomized Controlled Non-inferiority Clinical Trial

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当代医学科学(英文) 2023年第3期43卷 615-622页

作者： Xuan MO Tao JIANG Han WANG Yi ZHANG Department of Anesthesiology Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Healthand Wuhan Clinical Research Center for Geriatric AnesthesiaTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

Objective This study aimed to compare the postoperative analgesia and recovery of ultrasound-guided erector spinae plane block combined with serratus anterior plane block(ESPB combined with SAPB)versus thoracic paravertebral block(PVB)after thoracoscopic surgery.Methods Ninety-two patients who underwent video-assisted thoracoscopic surgery(VATS)were randomly divided into group S(n=46)and group P(n=46).After anesthesia induction,the same anesthesiologist performed ultrasound-guided ESPB at T5 and T7 levels combined with SAPB at the level of the fifth rib in the midaxillary line in group S and ultrasound-guided PVB at T5 and T7 levels in group P.Patients in both groups were given 40 mL of 0.4%ropivacaine.Eighty-six patients completed the study(group S,n=44;group P,n=42).The morphine consumption,visual analogue scale(VAS)scores at rest and coughing,and frequency of remedial analgesia were recorded at 1,2,4,8,and 24 h postoperatively.Pulmonary function parameters were recorded at 1,4,and 24 h postoperatively,and the quality of recovery(QoR)-15 score at 24 h postoperatively.The adverse effects,duration of chest tube drainage and length of stay were also recorded.Results The morphine consumption at postoperative 4 and 8 h and the incidence of ipsilateral shoulder pain(ISP)were significantly lower in group S than in group P.The QoR-15 questionnaire score at postoperative 24 h was significantly lower in group P than in group S(P<0.05).The morphine consumption was lower at 24 h postoperatively in group S than in group P,with no significant difference found yet.The morphine consumption at other observed times,VAS scores,pulmonary function parameters,frequency of remedial analgesia,duration of chest tube drainage,length of stay,and incidence of other adverse events were comparable between group S and group P.Conclusion Ultrasound-guided ESPB combined with SAPB is non-inferior to PVB in terms of morphine consumption at postoperative 24 h and postoperative recovery.But,this approach can significantly reduce morphine consumpti

关键词： erector spinae plane block serratus anterior plane block thoracic paravertebral block postoperative analgesia postoperative recovery

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erector spinae plane block at lower thoracic level for analgesia in lumbar spine surgery: A randomized controlled trial

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World Journal of Clinical Cases 2021年第19期9卷 5126-5134页

作者： Jing-Jing Zhang Teng-Jiao Zhang Zong-Yang Qu Yong Qiu Zhen Hua Department of Anesthesiology Beijing HospitalNational Center of GerontologyBeijing 100730China

BACKGROUND Patients undergoing lumbar spine surgery usually suffer severe pain in the postoperative period.The erector spinae plane block(ESPB),first published in 2016,can anesthetize the ventral and dorsal rami of thoracic nerves and produce an extensive multi-dermatomal sensory block.AIM To assess whether bilateral ultrasound-guided ESPB at a lower thoracic level could improve pain control and quality of recovery in patients undergoing lumbar spine surgery.METHODS A total of 60 patients aged 18-80 years scheduled to undergo lumbar spine surgery with general anesthesia were randomly assigned to two groups:ESPB group(preoperative bilateral ultrasound-guided ESPB at T10 vertebral level)and control group(no preoperative ESPB).Both groups received standard general anesthesia.The main indicator was the duration to the first patient controlled intravenous analgesia(PCIA)bolus.RESULTS In the ESPB group,the duration to the first PCIA bolus was significantly longer than that in the control group(h)[8.0(4.5,17.0)vs 1.0(0.5,6),P<0.01],and resting and coughing numerical rating scale(NRS)scores at 48 h post operation were significantly lower than those in the control group(P<0.05).There was no significant difference between the two groups regarding resting and coughing NRS scores at 24 h post operation.Sufentanil consumption during the operation was significantly lower in the ESPB group than in the control group(P<0.01),while there was no significant difference between the two groups regarding morphine consumption at 24 or 48 h post operation.In the ESPB group,Modified Observer’s Assessment of Alertness/Sedation score within 20 min after extubation was higher and duration in the post-anesthesia care unit was shorter than those in the control group(P<0.01).CONCLUSION In patients undergoing lumbar spine surgery,ultrasound-guided ESPB at a lower thoracic level improves the analgesic effect,reduces opioid consumption,and improves postoperative recovery.

关键词： erector spinae plane block Analgesia Opioids Lumbar spine surgery

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Liposomal Bupivacaine in erector spinae plane block and Interscalene block for Scapular and Proximal Humerus Resections

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Open Journal of Anesthesiology 2023年第7期13卷 135-139页

作者： Mohamad Ayoub Sree Kolli Husien Taleb Department of General Anesthesiology Cleveland Clinic Foundation Cleveland OH USA

erector spinae plane block (ESPB) is a novel fascial plane block that was first described in 2016. It is considered an alternative for brachial plexus blocks in shoulder surgeries as the erector spinae muscle extends to the cervical level. Herein, we present a successful multilevel ESPB plus an interscalene block using liposomal bupivacaine in a 45-year-old female patient with metastatic sarcoma who presented for scapula and proximal humerus resection. The post-operative course was smooth, and the patient was discharged home on post-operative day 2 with minimal narcotic requirements.

关键词： Acute Pain erector spinae plane block Phrenic Nerve Liposomal Bupivacaine—Regional Anesthesia Spindle Cell Sarcoma

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Ultrasound-Guided erector spinae plane block for Lumbar Spinal Stenosis Surgery

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Open Journal of Anesthesiology 2021年第3期11卷 72-84页

作者： Ayhan Şahin Onur Baran Ahmet Gültekin Gülcan Gücer Şahin Cavidan Arar Department of Anesthesiology and Reanimation Medical Faculty of Nam&#305 k Kemal University Tekirda&#287 Turkey Department of Radiology Medical Faculty of Nam&#305 k Kemal University Tekirda&#287 Turkey

Background: In this retrospective observational study, we evaluated patients who underwent elective lumbar stenosis surgery between February 1, 2019, and April 1, 2019. Patients who underwent surgery for lumbar spinal stenosis under general anesthesia alone were compared with those who underwent general anesthesia combined with erector spinae plane block. Aims: We aimed to retrospectively evaluate whether erector spinae plane block reduced opioid consumption following surgery for spinal stenosis. Study Design: A retrospective observational study. Methods: We collected data on the pain scores, time for the first requirement for patient-controlled analgesia with tramadol, the cumulative patient-controlled analgesia dose, requirement for rescue analgesia, time to first stand up postoperatively and the incidence of postoperative nausea and vomiting. Results: Sixty patients were included in the study. The numerical rating scale’s pain scores were significantly lower in the erector spinae plane group at 1, 2, 4, 6, 12 and 24 hours than in the general anesthesia group. The cumulative dose of patient-controlled analgesia with tramadol was higher in the general anesthesi

关键词： erector spinae plane block Ultrasound Guidance Lumbar Surgery Regional Anesthesia

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