The Effectiveness of Ultrasound-Guided, Continuous, Bilateral Erector Spinae Plane Block in Perioperative Pain Management of Patients Undergoing Colorectal Surgery: A Randomized, Controlled, Double Blind, Prospective Trial
Open and laparoscopic colorectal surgeries, while essential in the management of various colorectal pathologies, are associated with significant postoperative pain. Effective perioperative pain management strategies remain an anesthesiologic challenge. The erector spinae plane block (ESPB), a novel...
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MDPI AG
2023-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/23/7465 |
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| author | Freideriki Sifaki Theodosia Vogiatzaki Ioannis Mantzoros Eleni Koraki Panagiotis Christidis Manousos-Georgios Pramateftakis Vaia Tsapara Stella Bagntasarian Orestis Ioannidis Pelagia-Paraskevi Chloropoulou |
| author_facet | Freideriki Sifaki Theodosia Vogiatzaki Ioannis Mantzoros Eleni Koraki Panagiotis Christidis Manousos-Georgios Pramateftakis Vaia Tsapara Stella Bagntasarian Orestis Ioannidis Pelagia-Paraskevi Chloropoulou |
| author_sort | Freideriki Sifaki |
| collection | DOAJ |
| description | Open and laparoscopic colorectal surgeries, while essential in the management of various colorectal pathologies, are associated with significant postoperative pain. Effective perioperative pain management strategies remain an anesthesiologic challenge. The erector spinae plane block (ESPB), a novel peripheral nerve block, has gained attention for its potential in providing analgesia for a wide variety of surgeries. This study aimed to evaluate the effectiveness of continuous, bilateral ultrasound-guided ESPB in perioperative pain management of patients undergoing colectomy. This prospective, randomized, controlled, double-blind trial included 40 adult patients scheduled for elective open or laparoscopic colectomy. Patients undergoing open colectomy as well as patients undergoing laparoscopic colectomy were randomly allocated into two groups: the ESPB group (<i>n</i> = 20) and the control group (<i>n</i> = 20). All patients received preoperatively ultrasound-guided, bilateral ESPB with placement of catheters for continuous infusion. Patients in the ESPB group received 0.375% ropivacaine, while patients in the control group received sham blocks. All patients received standardized general anesthesia and multimodal postoperative analgesia. Pain scores, perioperative opioid consumption, and perioperative outcomes were assessed. Patients in the ESPB group required significantly less intraoperative (<i>p</i> < 0.001 for open colectomies, <i>p</i> = 0.002 for laparoscopic colectomies) and postoperative opioids (<i>p</i> < 0.001 for open colectomies, <i>p</i> = 0.002 for laparoscopic colectomies) and had higher quality of recovery scores on the third postoperative day (<i>p</i> = 0.002 for open and laparoscopic colectomies). Patients in the ESPB group did not exhibit lower postoperative pain scores compared to those in the control group (<i>p</i> > 0.05 at various time points), while patients in both groups reported comparable satisfaction scores with their perioperative pain management (<i>p</i> = 0.061 for open colectomies, and <i>p</i> = 0.078 in laparoscopic colectomies). No complications were reported. ESPB is a novel and effective strategy in reducing perioperative opioid consumption in patients undergoing colectomy. This technique, as part of a multimodal analgesic plan and enhanced recovery after surgery protocols, can be proven valuable in improving the comfort and satisfaction of patients undergoing colorectal surgery. |
| first_indexed | 2024-03-09T01:47:53Z |
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| id | doaj.art-685940b19bb24f9c8668d18b021ff187 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T01:47:53Z |
| publishDate | 2023-12-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-685940b19bb24f9c8668d18b021ff1872023-12-08T15:20:05ZengMDPI AGJournal of Clinical Medicine2077-03832023-12-011223746510.3390/jcm12237465The Effectiveness of Ultrasound-Guided, Continuous, Bilateral Erector Spinae Plane Block in Perioperative Pain Management of Patients Undergoing Colorectal Surgery: A Randomized, Controlled, Double Blind, Prospective TrialFreideriki Sifaki0Theodosia Vogiatzaki1Ioannis Mantzoros2Eleni Koraki3Panagiotis Christidis4Manousos-Georgios Pramateftakis5Vaia Tsapara6Stella Bagntasarian7Orestis Ioannidis8Pelagia-Paraskevi Chloropoulou9Department of Anesthesiology, “Papageorgiou” General Hospital of Thessaloniki, 56429 Thessaloniki, GreeceDepartment of Anesthesiology, Medical School, Democritus University of Thrace, General Hospital of Alexandroupolis, 68100 Alexandroupoli, Greece4th Department of Surgery, Medical School, Aristotle University of Thessaloniki, “Georgios Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, GreeceDepartment of Anesthesiology, “Papageorgiou” General Hospital of Thessaloniki, 56429 Thessaloniki, Greece4th Department of Surgery, Medical School, Aristotle University of Thessaloniki, “Georgios Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece4th Department of Surgery, Medical School, Aristotle University of Thessaloniki, “Georgios Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, GreeceDepartment of Anesthesiology, “Georgios Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, GreeceDepartment of Anesthesiology, “Georgios Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, Greece4th Department of Surgery, Medical School, Aristotle University of Thessaloniki, “Georgios Papanikolaou” General Hospital of Thessaloniki, 57010 Thessaloniki, GreeceDepartment of Anesthesiology, Medical School, Democritus University of Thrace, General Hospital of Alexandroupolis, 68100 Alexandroupoli, GreeceOpen and laparoscopic colorectal surgeries, while essential in the management of various colorectal pathologies, are associated with significant postoperative pain. Effective perioperative pain management strategies remain an anesthesiologic challenge. The erector spinae plane block (ESPB), a novel peripheral nerve block, has gained attention for its potential in providing analgesia for a wide variety of surgeries. This study aimed to evaluate the effectiveness of continuous, bilateral ultrasound-guided ESPB in perioperative pain management of patients undergoing colectomy. This prospective, randomized, controlled, double-blind trial included 40 adult patients scheduled for elective open or laparoscopic colectomy. Patients undergoing open colectomy as well as patients undergoing laparoscopic colectomy were randomly allocated into two groups: the ESPB group (<i>n</i> = 20) and the control group (<i>n</i> = 20). All patients received preoperatively ultrasound-guided, bilateral ESPB with placement of catheters for continuous infusion. Patients in the ESPB group received 0.375% ropivacaine, while patients in the control group received sham blocks. All patients received standardized general anesthesia and multimodal postoperative analgesia. Pain scores, perioperative opioid consumption, and perioperative outcomes were assessed. Patients in the ESPB group required significantly less intraoperative (<i>p</i> < 0.001 for open colectomies, <i>p</i> = 0.002 for laparoscopic colectomies) and postoperative opioids (<i>p</i> < 0.001 for open colectomies, <i>p</i> = 0.002 for laparoscopic colectomies) and had higher quality of recovery scores on the third postoperative day (<i>p</i> = 0.002 for open and laparoscopic colectomies). Patients in the ESPB group did not exhibit lower postoperative pain scores compared to those in the control group (<i>p</i> > 0.05 at various time points), while patients in both groups reported comparable satisfaction scores with their perioperative pain management (<i>p</i> = 0.061 for open colectomies, and <i>p</i> = 0.078 in laparoscopic colectomies). No complications were reported. ESPB is a novel and effective strategy in reducing perioperative opioid consumption in patients undergoing colectomy. This technique, as part of a multimodal analgesic plan and enhanced recovery after surgery protocols, can be proven valuable in improving the comfort and satisfaction of patients undergoing colorectal surgery.https://www.mdpi.com/2077-0383/12/23/7465abdominal surgerycolorectal surgeryerector spinae plane blockregional anesthesiaperioperative pain managementpostoperative analgesia |
| spellingShingle | Freideriki Sifaki Theodosia Vogiatzaki Ioannis Mantzoros Eleni Koraki Panagiotis Christidis Manousos-Georgios Pramateftakis Vaia Tsapara Stella Bagntasarian Orestis Ioannidis Pelagia-Paraskevi Chloropoulou The Effectiveness of Ultrasound-Guided, Continuous, Bilateral Erector Spinae Plane Block in Perioperative Pain Management of Patients Undergoing Colorectal Surgery: A Randomized, Controlled, Double Blind, Prospective Trial Journal of Clinical Medicine abdominal surgery colorectal surgery erector spinae plane block regional anesthesia perioperative pain management postoperative analgesia |
| title | The Effectiveness of Ultrasound-Guided, Continuous, Bilateral Erector Spinae Plane Block in Perioperative Pain Management of Patients Undergoing Colorectal Surgery: A Randomized, Controlled, Double Blind, Prospective Trial |
| title_full | The Effectiveness of Ultrasound-Guided, Continuous, Bilateral Erector Spinae Plane Block in Perioperative Pain Management of Patients Undergoing Colorectal Surgery: A Randomized, Controlled, Double Blind, Prospective Trial |
| title_fullStr | The Effectiveness of Ultrasound-Guided, Continuous, Bilateral Erector Spinae Plane Block in Perioperative Pain Management of Patients Undergoing Colorectal Surgery: A Randomized, Controlled, Double Blind, Prospective Trial |
| title_full_unstemmed | The Effectiveness of Ultrasound-Guided, Continuous, Bilateral Erector Spinae Plane Block in Perioperative Pain Management of Patients Undergoing Colorectal Surgery: A Randomized, Controlled, Double Blind, Prospective Trial |
| title_short | The Effectiveness of Ultrasound-Guided, Continuous, Bilateral Erector Spinae Plane Block in Perioperative Pain Management of Patients Undergoing Colorectal Surgery: A Randomized, Controlled, Double Blind, Prospective Trial |
| title_sort | effectiveness of ultrasound guided continuous bilateral erector spinae plane block in perioperative pain management of patients undergoing colorectal surgery a randomized controlled double blind prospective trial |
| topic | abdominal surgery colorectal surgery erector spinae plane block regional anesthesia perioperative pain management postoperative analgesia |
| url | https://www.mdpi.com/2077-0383/12/23/7465 |
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