A comparison of ultrasound guided bilateral single injection shot Erector Spinae Plane blocks versus wound infiltration for post-operative analgesia in laparoscopic assisted colonic surgery- a prospective randomised study
Abstract Background Both wound infiltration (WI) with local anaesthetic and Erector Spinae Plane block (ESPB) have been described for post-operative analgesia after abdominal surgery. This study compared the efficacy of WI versus ESPB for post-operative analgesia after laparoscopic assisted colonic...
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-021-01474-8 |
| _version_ | 1818395157755592704 |
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| author | V. Rao Kadam G. Ludbrook R. M. van Wijk P. Hewett V. Thiruvenkatarajan S. Edwards P. Williams S. Adhikary |
| author_facet | V. Rao Kadam G. Ludbrook R. M. van Wijk P. Hewett V. Thiruvenkatarajan S. Edwards P. Williams S. Adhikary |
| author_sort | V. Rao Kadam |
| collection | DOAJ |
| description | Abstract Background Both wound infiltration (WI) with local anaesthetic and Erector Spinae Plane block (ESPB) have been described for post-operative analgesia after abdominal surgery. This study compared the efficacy of WI versus ESPB for post-operative analgesia after laparoscopic assisted colonic surgery. Methods Seventy-two patients between 18 and 85 years of age undergoing elective surgery were randomised to receive either WI or ESPB. In the WI group a 40 ml bolus of 0.5% Ropivacaine, infiltrated at the ports and minimally invasive wound at subcutaneous and fascia layers. In the ESPB group at T8 level, under ultrasound guidance, a 22-gauge nerve block needle was passed through the Erector Spinae muscle to reach its fascia. A dose up to 40 ml of 0.5% Ropivacaine, divided into two equal volumes, was injected at each side. Both groups had a multimodal analgesic regime, including regular Paracetamol, dexamethasone and patient-controlled analgesia (PCA) with Fentanyl. The primary end point was a post-operative pain score utilising a verbal Numerical Rating Score (NRS, 0–10) on rest and coughing in the post anaesthetic care unit (PACU) and in the first 24 h. Secondary outcomes measured were: opioid usage, length of stay and any clinical adverse events. Results There was no significant treatment difference in PACU NRS at rest and coughing (p-values 0. 382 and 0.595respectively). Similarly, there were no significant differences in first 24 h NRS at rest and coughing (p-values 0.285 and 0.431 respectively). There was no significant difference in Fentanyl use in PACU or in the first 24 h (p- values 0.900 and 0.783 respectively). Neither was there a significant difference found in mean total Fentanyl use between ESPB and WI groups (p-value 0.787). Conclusion Our observations found both interventions had an overall similar efficacy. Trial registration The study was registered with the Australian New Zealand Clinical Trial Registry (ACTRN: 12619000113156 ). |
| first_indexed | 2024-12-14T06:12:39Z |
| format | Article |
| id | doaj.art-d9a19799449541688d68346af23810e9 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-14T06:12:39Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
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| series | BMC Anesthesiology |
| spelling | doaj.art-d9a19799449541688d68346af23810e92022-12-21T23:14:07ZengBMCBMC Anesthesiology1471-22532021-10-012111710.1186/s12871-021-01474-8A comparison of ultrasound guided bilateral single injection shot Erector Spinae Plane blocks versus wound infiltration for post-operative analgesia in laparoscopic assisted colonic surgery- a prospective randomised studyV. Rao Kadam0G. Ludbrook1R. M. van Wijk2P. Hewett3V. Thiruvenkatarajan4S. Edwards5P. Williams6S. Adhikary7Acute Care Medicine, The University of Adelaide, The Queen Elizabeth HospitalAcute Care Medicine, University of Adelaide, Royal Adelaide HospitalAcute Care Medicine, The University of Adelaide, The Queen Elizabeth HospitalDepartment of Surgery, University of Adelaide, The Queen Elizabeth HospitalAcute Care Medicine, The University of Adelaide, The Queen Elizabeth HospitalAdelaide Health Technology Assessment, School of Public Health, University of AdelaideAcute Care Medicine, The University of Adelaide, The Queen Elizabeth HospitalDepartment of Anesthesiology and Perioperative Medicine, Penn State Hershey Medical Center, Penn State College of MedicineAbstract Background Both wound infiltration (WI) with local anaesthetic and Erector Spinae Plane block (ESPB) have been described for post-operative analgesia after abdominal surgery. This study compared the efficacy of WI versus ESPB for post-operative analgesia after laparoscopic assisted colonic surgery. Methods Seventy-two patients between 18 and 85 years of age undergoing elective surgery were randomised to receive either WI or ESPB. In the WI group a 40 ml bolus of 0.5% Ropivacaine, infiltrated at the ports and minimally invasive wound at subcutaneous and fascia layers. In the ESPB group at T8 level, under ultrasound guidance, a 22-gauge nerve block needle was passed through the Erector Spinae muscle to reach its fascia. A dose up to 40 ml of 0.5% Ropivacaine, divided into two equal volumes, was injected at each side. Both groups had a multimodal analgesic regime, including regular Paracetamol, dexamethasone and patient-controlled analgesia (PCA) with Fentanyl. The primary end point was a post-operative pain score utilising a verbal Numerical Rating Score (NRS, 0–10) on rest and coughing in the post anaesthetic care unit (PACU) and in the first 24 h. Secondary outcomes measured were: opioid usage, length of stay and any clinical adverse events. Results There was no significant treatment difference in PACU NRS at rest and coughing (p-values 0. 382 and 0.595respectively). Similarly, there were no significant differences in first 24 h NRS at rest and coughing (p-values 0.285 and 0.431 respectively). There was no significant difference in Fentanyl use in PACU or in the first 24 h (p- values 0.900 and 0.783 respectively). Neither was there a significant difference found in mean total Fentanyl use between ESPB and WI groups (p-value 0.787). Conclusion Our observations found both interventions had an overall similar efficacy. Trial registration The study was registered with the Australian New Zealand Clinical Trial Registry (ACTRN: 12619000113156 ).https://doi.org/10.1186/s12871-021-01474-8UltrasoundErector Spinae PlanePost-operative analgesiaLocal anaesthetic |
| spellingShingle | V. Rao Kadam G. Ludbrook R. M. van Wijk P. Hewett V. Thiruvenkatarajan S. Edwards P. Williams S. Adhikary A comparison of ultrasound guided bilateral single injection shot Erector Spinae Plane blocks versus wound infiltration for post-operative analgesia in laparoscopic assisted colonic surgery- a prospective randomised study BMC Anesthesiology Ultrasound Erector Spinae Plane Post-operative analgesia Local anaesthetic |
| title | A comparison of ultrasound guided bilateral single injection shot Erector Spinae Plane blocks versus wound infiltration for post-operative analgesia in laparoscopic assisted colonic surgery- a prospective randomised study |
| title_full | A comparison of ultrasound guided bilateral single injection shot Erector Spinae Plane blocks versus wound infiltration for post-operative analgesia in laparoscopic assisted colonic surgery- a prospective randomised study |
| title_fullStr | A comparison of ultrasound guided bilateral single injection shot Erector Spinae Plane blocks versus wound infiltration for post-operative analgesia in laparoscopic assisted colonic surgery- a prospective randomised study |
| title_full_unstemmed | A comparison of ultrasound guided bilateral single injection shot Erector Spinae Plane blocks versus wound infiltration for post-operative analgesia in laparoscopic assisted colonic surgery- a prospective randomised study |
| title_short | A comparison of ultrasound guided bilateral single injection shot Erector Spinae Plane blocks versus wound infiltration for post-operative analgesia in laparoscopic assisted colonic surgery- a prospective randomised study |
| title_sort | comparison of ultrasound guided bilateral single injection shot erector spinae plane blocks versus wound infiltration for post operative analgesia in laparoscopic assisted colonic surgery a prospective randomised study |
| topic | Ultrasound Erector Spinae Plane Post-operative analgesia Local anaesthetic |
| url | https://doi.org/10.1186/s12871-021-01474-8 |
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