Analgesic Strategies for Urologic Videolaparoscopic or Robotic Surgery in the Context of an Enhanced Recovery after Surgery Protocol: A Prospective Study Comparing Erector Spinae Plane Block versus Transversus Abdominis Plane Block
Regional anesthesia in postoperative pain management has developed in recent years, especially with the advent of fascial plane blocks. This study aims to compare the ultrasound-guided bilateral erector spinae plane block (ESPB) versus the ultrasound-guided bilateral transversus abdominis plane bloc...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/2/383 |
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| author | Marco Micali Giada Cucciolini Giulia Bertoni Michela Gandini Marco Lattuada Gregorio Santori Carlo Introini Francesco Corradi Claudia Brusasco |
| author_facet | Marco Micali Giada Cucciolini Giulia Bertoni Michela Gandini Marco Lattuada Gregorio Santori Carlo Introini Francesco Corradi Claudia Brusasco |
| author_sort | Marco Micali |
| collection | DOAJ |
| description | Regional anesthesia in postoperative pain management has developed in recent years, especially with the advent of fascial plane blocks. This study aims to compare the ultrasound-guided bilateral erector spinae plane block (ESPB) versus the ultrasound-guided bilateral transversus abdominis plane block (TAPB) on postoperative analgesia after laparoscopic or robotic urologic surgery. This was a prospective observational study; 97 patients (ESPB-group) received bilateral ultrasound-guided ESPB with 20 mL of ropivacaine 0.375% plus 0.5 mcg/kg of dexmedetomidine in each side at the level of T7–T9 and 93 patients (TAPB-group) received bilateral ultrasound-guided TAPB with 20 mL ropivacaine 0.375% or 0.25%. The primary outcome was the postoperative numeric rating scale (NRS) pain score, which was significantly lower in the ESPB group on postoperative days 0, 1, 2, and 3 (<i>p</i> < 0.001) and, consequently, the number of patients requiring postoperative supplemental analgesic rescue therapies was significantly lower (<i>p</i> < 0.001). Concerning the secondary outcomes, consumption of ropivacaine was significantly lower in the group (<i>p</i> < 0.001) and the total amount of analgesic rescue doses was significantly lower in the ESPB-group than the TAPB-group in postoperative days from 2 to 4 (1 vs. 3, <i>p</i> > 0.001). Incidence of postoperative nausea and vomiting was higher in the TAPB group and no block-related complications were observed. Our data indicate that ESPB provides postoperative pain control at least as good as TAPB plus morphine, with less local anesthetic needed. |
| first_indexed | 2024-03-08T09:51:45Z |
| format | Article |
| id | doaj.art-4329feef57e4493886519fb18e23b501 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T09:51:45Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4329feef57e4493886519fb18e23b5012024-01-29T14:01:21ZengMDPI AGJournal of Clinical Medicine2077-03832024-01-0113238310.3390/jcm13020383Analgesic Strategies for Urologic Videolaparoscopic or Robotic Surgery in the Context of an Enhanced Recovery after Surgery Protocol: A Prospective Study Comparing Erector Spinae Plane Block versus Transversus Abdominis Plane BlockMarco Micali0Giada Cucciolini1Giulia Bertoni2Michela Gandini3Marco Lattuada4Gregorio Santori5Carlo Introini6Francesco Corradi7Claudia Brusasco8Anaesthesia and Intensive Care Unit, E.O. Ospedali Galliera, 16128 Genoa, ItalyDepartment of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, ItalyAnaesthesia and Intensive Care Unit, NOA—Nuovo Ospedale Apuano, 54100 Massa, ItalyAnaesthesia and Intensive Care Unit, E.O. Ospedali Galliera, 16128 Genoa, ItalyAnaesthesia and Intensive Care Unit, E.O. Ospedali Galliera, 16128 Genoa, ItalyDepartment of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16126 Genoa, ItalyDepartment of Abdominal Surgery, Urology Unit, E.O. Ospedali Galliera, 12128 Genoa, ItalyDepartment of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, ItalyAnaesthesia and Intensive Care Unit, E.O. Ospedali Galliera, 16128 Genoa, ItalyRegional anesthesia in postoperative pain management has developed in recent years, especially with the advent of fascial plane blocks. This study aims to compare the ultrasound-guided bilateral erector spinae plane block (ESPB) versus the ultrasound-guided bilateral transversus abdominis plane block (TAPB) on postoperative analgesia after laparoscopic or robotic urologic surgery. This was a prospective observational study; 97 patients (ESPB-group) received bilateral ultrasound-guided ESPB with 20 mL of ropivacaine 0.375% plus 0.5 mcg/kg of dexmedetomidine in each side at the level of T7–T9 and 93 patients (TAPB-group) received bilateral ultrasound-guided TAPB with 20 mL ropivacaine 0.375% or 0.25%. The primary outcome was the postoperative numeric rating scale (NRS) pain score, which was significantly lower in the ESPB group on postoperative days 0, 1, 2, and 3 (<i>p</i> < 0.001) and, consequently, the number of patients requiring postoperative supplemental analgesic rescue therapies was significantly lower (<i>p</i> < 0.001). Concerning the secondary outcomes, consumption of ropivacaine was significantly lower in the group (<i>p</i> < 0.001) and the total amount of analgesic rescue doses was significantly lower in the ESPB-group than the TAPB-group in postoperative days from 2 to 4 (1 vs. 3, <i>p</i> > 0.001). Incidence of postoperative nausea and vomiting was higher in the TAPB group and no block-related complications were observed. Our data indicate that ESPB provides postoperative pain control at least as good as TAPB plus morphine, with less local anesthetic needed.https://www.mdpi.com/2077-0383/13/2/383postoperative analgesiaplexus abdominal blocksabdominal surgerylaparoscopic urologic surgeryrobotic urologic surgerypost-operative nausea and vomiting |
| spellingShingle | Marco Micali Giada Cucciolini Giulia Bertoni Michela Gandini Marco Lattuada Gregorio Santori Carlo Introini Francesco Corradi Claudia Brusasco Analgesic Strategies for Urologic Videolaparoscopic or Robotic Surgery in the Context of an Enhanced Recovery after Surgery Protocol: A Prospective Study Comparing Erector Spinae Plane Block versus Transversus Abdominis Plane Block Journal of Clinical Medicine postoperative analgesia plexus abdominal blocks abdominal surgery laparoscopic urologic surgery robotic urologic surgery post-operative nausea and vomiting |
| title | Analgesic Strategies for Urologic Videolaparoscopic or Robotic Surgery in the Context of an Enhanced Recovery after Surgery Protocol: A Prospective Study Comparing Erector Spinae Plane Block versus Transversus Abdominis Plane Block |
| title_full | Analgesic Strategies for Urologic Videolaparoscopic or Robotic Surgery in the Context of an Enhanced Recovery after Surgery Protocol: A Prospective Study Comparing Erector Spinae Plane Block versus Transversus Abdominis Plane Block |
| title_fullStr | Analgesic Strategies for Urologic Videolaparoscopic or Robotic Surgery in the Context of an Enhanced Recovery after Surgery Protocol: A Prospective Study Comparing Erector Spinae Plane Block versus Transversus Abdominis Plane Block |
| title_full_unstemmed | Analgesic Strategies for Urologic Videolaparoscopic or Robotic Surgery in the Context of an Enhanced Recovery after Surgery Protocol: A Prospective Study Comparing Erector Spinae Plane Block versus Transversus Abdominis Plane Block |
| title_short | Analgesic Strategies for Urologic Videolaparoscopic or Robotic Surgery in the Context of an Enhanced Recovery after Surgery Protocol: A Prospective Study Comparing Erector Spinae Plane Block versus Transversus Abdominis Plane Block |
| title_sort | analgesic strategies for urologic videolaparoscopic or robotic surgery in the context of an enhanced recovery after surgery protocol a prospective study comparing erector spinae plane block versus transversus abdominis plane block |
| topic | postoperative analgesia plexus abdominal blocks abdominal surgery laparoscopic urologic surgery robotic urologic surgery post-operative nausea and vomiting |
| url | https://www.mdpi.com/2077-0383/13/2/383 |
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