Comparison of the effects of one-level and bi-level pre-incisional erector spinae plane block on postoperative acute pain in video-assisted thoracoscopic surgery; a prospective, randomized, double-blind trial
Abstract Background This prospective, randomized, double-blind trial aimed to compare the postoperative analgesic efficacy of One-Level pre-incisional erector spinae plane block (ESPB) and Bi-Level pre-incisional ESPB in patients undergoing video-assisted thoracic surgery (VATS). Methods This pilot...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-023-02232-8 |
| _version_ | 1797451696190783488 |
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| author | Emine Nilgün Zengin Musa Zengin Hülya Yiğit Hilal Sazak Sumru Şekerci Ali Alagöz |
| author_facet | Emine Nilgün Zengin Musa Zengin Hülya Yiğit Hilal Sazak Sumru Şekerci Ali Alagöz |
| author_sort | Emine Nilgün Zengin |
| collection | DOAJ |
| description | Abstract Background This prospective, randomized, double-blind trial aimed to compare the postoperative analgesic efficacy of One-Level pre-incisional erector spinae plane block (ESPB) and Bi-Level pre-incisional ESPB in patients undergoing video-assisted thoracic surgery (VATS). Methods This pilot trial was conducted between April 2022 and February 2023 with sixty patients. The patients were randomly divided into two groups. In One-Level ESPB Group (n = 30) block was performed at the thoracal(T)5 level with the 30 ml 0.25% bupivacaine. In the Bi-Level ESPB Group (n = 30) block was performed at T4 and T6 levels by using 15 ml of 0.25% bupivacaine for each level. In the postoperative period, 50 mg dexketoprofen every 12 h and 1 g paracetamol every 8 h were given intravenously (IV). Patient-controlled analgesia (PCA) prepared with morphine was applied to the patients. 0.5 mg/kg of tramadol was administered via IV for rescue analgesia. Visual analog scale (VAS) scores were recorded in the postoperative 1st, 2nd, 4th, 12th, 24th, and 48th -hours. The need for additional analgesics and side effects were recorded. In two groups, patients’ demographics and postoperative hemodynamic data were recorded. Results VAS scores at resting were statistically significantly higher at the 1st (p: 0.002) and 4th -hour (p: 0.001) in the One-Level ESPB. When the groups were evaluated in terms of VAS coughing scores, the 4th -hour (p: 0.001) VAS coughing scores results were found to be statistically significantly higher in the One-Level ESPB group. In terms of VAS values evaluated during follow-up, the rates of VAS coughing score > 3 values were found to be statistically significantly lower in the Bi-Level ESPB group (p: 0.011). There was no statistically significant difference between the groups in terms of side effects, morphine consumption, and additional analgesic use (p > 0.05). Conclusions Adequate analgesia was achieved in the early postoperative period in the group treated with Bi-Level ESPB with similar morphine consumption and side effects. This may be an advantage, especially in the early postoperative period when the pain is quite intense. |
| first_indexed | 2024-03-09T14:58:14Z |
| format | Article |
| id | doaj.art-84070525aa8f4914aa04027d2dff5168 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-03-09T14:58:14Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-84070525aa8f4914aa04027d2dff51682023-11-26T14:03:19ZengBMCBMC Anesthesiology1471-22532023-08-012311910.1186/s12871-023-02232-8Comparison of the effects of one-level and bi-level pre-incisional erector spinae plane block on postoperative acute pain in video-assisted thoracoscopic surgery; a prospective, randomized, double-blind trialEmine Nilgün Zengin0Musa Zengin1Hülya Yiğit2Hilal Sazak3Sumru Şekerci4Ali Alagöz5Ankara Bilkent City Hospital, Anesthesiology and Reanimation Clinic, Ministry of HealthAnkara Etlik City Hospital, Anesthesiology and Reanimation Clinic, Ministry of HealthAnkara Bilkent City Hospital, Anesthesiology and Reanimation Clinic, Ministry of HealthUniversity of Health Sciences, Ankara Atatürk Sanatorium Training and Research HospitalAnkara Bilkent City Hospital, Anesthesiology and Reanimation Clinic, Ministry of HealthUniversity of Health Sciences, Ankara Atatürk Sanatorium Training and Research HospitalAbstract Background This prospective, randomized, double-blind trial aimed to compare the postoperative analgesic efficacy of One-Level pre-incisional erector spinae plane block (ESPB) and Bi-Level pre-incisional ESPB in patients undergoing video-assisted thoracic surgery (VATS). Methods This pilot trial was conducted between April 2022 and February 2023 with sixty patients. The patients were randomly divided into two groups. In One-Level ESPB Group (n = 30) block was performed at the thoracal(T)5 level with the 30 ml 0.25% bupivacaine. In the Bi-Level ESPB Group (n = 30) block was performed at T4 and T6 levels by using 15 ml of 0.25% bupivacaine for each level. In the postoperative period, 50 mg dexketoprofen every 12 h and 1 g paracetamol every 8 h were given intravenously (IV). Patient-controlled analgesia (PCA) prepared with morphine was applied to the patients. 0.5 mg/kg of tramadol was administered via IV for rescue analgesia. Visual analog scale (VAS) scores were recorded in the postoperative 1st, 2nd, 4th, 12th, 24th, and 48th -hours. The need for additional analgesics and side effects were recorded. In two groups, patients’ demographics and postoperative hemodynamic data were recorded. Results VAS scores at resting were statistically significantly higher at the 1st (p: 0.002) and 4th -hour (p: 0.001) in the One-Level ESPB. When the groups were evaluated in terms of VAS coughing scores, the 4th -hour (p: 0.001) VAS coughing scores results were found to be statistically significantly higher in the One-Level ESPB group. In terms of VAS values evaluated during follow-up, the rates of VAS coughing score > 3 values were found to be statistically significantly lower in the Bi-Level ESPB group (p: 0.011). There was no statistically significant difference between the groups in terms of side effects, morphine consumption, and additional analgesic use (p > 0.05). Conclusions Adequate analgesia was achieved in the early postoperative period in the group treated with Bi-Level ESPB with similar morphine consumption and side effects. This may be an advantage, especially in the early postoperative period when the pain is quite intense.https://doi.org/10.1186/s12871-023-02232-8Acute painBi-level erector spinae plane blockPostoperative painVideo-assisted thoracic surgery |
| spellingShingle | Emine Nilgün Zengin Musa Zengin Hülya Yiğit Hilal Sazak Sumru Şekerci Ali Alagöz Comparison of the effects of one-level and bi-level pre-incisional erector spinae plane block on postoperative acute pain in video-assisted thoracoscopic surgery; a prospective, randomized, double-blind trial BMC Anesthesiology Acute pain Bi-level erector spinae plane block Postoperative pain Video-assisted thoracic surgery |
| title | Comparison of the effects of one-level and bi-level pre-incisional erector spinae plane block on postoperative acute pain in video-assisted thoracoscopic surgery; a prospective, randomized, double-blind trial |
| title_full | Comparison of the effects of one-level and bi-level pre-incisional erector spinae plane block on postoperative acute pain in video-assisted thoracoscopic surgery; a prospective, randomized, double-blind trial |
| title_fullStr | Comparison of the effects of one-level and bi-level pre-incisional erector spinae plane block on postoperative acute pain in video-assisted thoracoscopic surgery; a prospective, randomized, double-blind trial |
| title_full_unstemmed | Comparison of the effects of one-level and bi-level pre-incisional erector spinae plane block on postoperative acute pain in video-assisted thoracoscopic surgery; a prospective, randomized, double-blind trial |
| title_short | Comparison of the effects of one-level and bi-level pre-incisional erector spinae plane block on postoperative acute pain in video-assisted thoracoscopic surgery; a prospective, randomized, double-blind trial |
| title_sort | comparison of the effects of one level and bi level pre incisional erector spinae plane block on postoperative acute pain in video assisted thoracoscopic surgery a prospective randomized double blind trial |
| topic | Acute pain Bi-level erector spinae plane block Postoperative pain Video-assisted thoracic surgery |
| url | https://doi.org/10.1186/s12871-023-02232-8 |
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