The effect of erector spinae plane block on fentanyl consumption during open abdominal hysterectomy: a randomised controlled study
Abstract Background Perioperative analgesia is very important during an abdominal hysterectomy. Determining the impact of the erector spinae plane block (ESPB) on patients undergoing an open abdominal hysterectomy while under general anesthesia was our aim. Methods In order to create equal groups, 1...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-06-01
|
| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-023-02156-3 |
| _version_ | 1797806546573328384 |
|---|---|
| author | Mohamed Ahmed Hamed Maged Labib Boules Mohamed Abd El Moniem Mahmoud Rana Ahmed Abdelghaffar |
| author_facet | Mohamed Ahmed Hamed Maged Labib Boules Mohamed Abd El Moniem Mahmoud Rana Ahmed Abdelghaffar |
| author_sort | Mohamed Ahmed Hamed |
| collection | DOAJ |
| description | Abstract Background Perioperative analgesia is very important during an abdominal hysterectomy. Determining the impact of the erector spinae plane block (ESPB) on patients undergoing an open abdominal hysterectomy while under general anesthesia was our aim. Methods In order to create equal groups, 100 patients who underwent elective open abdominal hysterectomies under general anesthesia were enlisted. The preoperative bilateral ESPB with 20 ml of bupivacaine 0.25% was administered to the ESPB group (n = 50). The same procedure was performed on the control group (n = 50), but they received a 20-ml saline injection instead. The primary outcome is the total amount of fentanyl consumed during surgery. Results We found that the mean (SD) intraoperative fentanyl consumption was significantly lower in the ESPB group than in the control group (82.9 (27.4) g vs. 148.5 (44.8) g, with a 95% CI = -80.3 to -50.8; p 0.001). Likewise, mean (SD) postoperative fentanyl consumption was significantly lower in the ESPB group than in the control group (442.4 (17.8) g vs. 477.9 (10.4) g, with a 95% CI = -41.3 to -29.7; p 0.001). On the other hand, there is no statistically significant difference between the two study groups regarding sevoflurane consumption (89.2 (19.5) ml vs. 92.4 (15.3) ml, with a 95% CI = -10.1 to 3.8; p 0.4). We documented that during the post-operative period (0–24 h), VAS scores at rest were, on average, 1.03 units lower in the ESPB group (estimate = -1.03, 95% CI = -1.16-(-0.86), t = -14.9, p-value 0.001), and VAS scores during cough were, on average, 1.07 units lower in the ESPB group (estimate = -1.07, 95% CI = -1.21-(-0.93), t = -14.8, p-value 0.001). Conclusion Bilateral ESPB can be utilized as an adjuvant method to reduce intraoperative fentanyl consumption and enhance postoperative pain control in patients undergoing open total abdominal hysterectomy under general anesthesia. It is effective, secure, and little obtrusive. Trial registration No protocol revisions or study amendments have been made since the trial's inception, according to the information on ClinicalTrials.gov (NCT05072184; principal investigator: Mohamed Ahmed Hamed; date of registration: October 28, 2021). |
| first_indexed | 2024-03-13T06:08:54Z |
| format | Article |
| id | doaj.art-e7d5a67b725a46d99673e3b5c5d75bd7 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-03-13T06:08:54Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-e7d5a67b725a46d99673e3b5c5d75bd72023-06-11T11:23:40ZengBMCBMC Anesthesiology1471-22532023-06-012311810.1186/s12871-023-02156-3The effect of erector spinae plane block on fentanyl consumption during open abdominal hysterectomy: a randomised controlled studyMohamed Ahmed Hamed0Maged Labib Boules1Mohamed Abd El Moniem Mahmoud2Rana Ahmed Abdelghaffar3Department of Anesthesiology, Faculty of Medicine, Fayoum UniversityDepartment of Anesthesiology, Faculty of Medicine, Fayoum UniversityDepartment of Anesthesiology, Faculty of Medicine, Fayoum UniversityDepartment of Anesthesiology, Faculty of Medicine, Fayoum UniversityAbstract Background Perioperative analgesia is very important during an abdominal hysterectomy. Determining the impact of the erector spinae plane block (ESPB) on patients undergoing an open abdominal hysterectomy while under general anesthesia was our aim. Methods In order to create equal groups, 100 patients who underwent elective open abdominal hysterectomies under general anesthesia were enlisted. The preoperative bilateral ESPB with 20 ml of bupivacaine 0.25% was administered to the ESPB group (n = 50). The same procedure was performed on the control group (n = 50), but they received a 20-ml saline injection instead. The primary outcome is the total amount of fentanyl consumed during surgery. Results We found that the mean (SD) intraoperative fentanyl consumption was significantly lower in the ESPB group than in the control group (82.9 (27.4) g vs. 148.5 (44.8) g, with a 95% CI = -80.3 to -50.8; p 0.001). Likewise, mean (SD) postoperative fentanyl consumption was significantly lower in the ESPB group than in the control group (442.4 (17.8) g vs. 477.9 (10.4) g, with a 95% CI = -41.3 to -29.7; p 0.001). On the other hand, there is no statistically significant difference between the two study groups regarding sevoflurane consumption (89.2 (19.5) ml vs. 92.4 (15.3) ml, with a 95% CI = -10.1 to 3.8; p 0.4). We documented that during the post-operative period (0–24 h), VAS scores at rest were, on average, 1.03 units lower in the ESPB group (estimate = -1.03, 95% CI = -1.16-(-0.86), t = -14.9, p-value 0.001), and VAS scores during cough were, on average, 1.07 units lower in the ESPB group (estimate = -1.07, 95% CI = -1.21-(-0.93), t = -14.8, p-value 0.001). Conclusion Bilateral ESPB can be utilized as an adjuvant method to reduce intraoperative fentanyl consumption and enhance postoperative pain control in patients undergoing open total abdominal hysterectomy under general anesthesia. It is effective, secure, and little obtrusive. Trial registration No protocol revisions or study amendments have been made since the trial's inception, according to the information on ClinicalTrials.gov (NCT05072184; principal investigator: Mohamed Ahmed Hamed; date of registration: October 28, 2021).https://doi.org/10.1186/s12871-023-02156-3Fentanyl consumptionPostoperative painAbdominal hysterectomyErector spinae plane block |
| spellingShingle | Mohamed Ahmed Hamed Maged Labib Boules Mohamed Abd El Moniem Mahmoud Rana Ahmed Abdelghaffar The effect of erector spinae plane block on fentanyl consumption during open abdominal hysterectomy: a randomised controlled study BMC Anesthesiology Fentanyl consumption Postoperative pain Abdominal hysterectomy Erector spinae plane block |
| title | The effect of erector spinae plane block on fentanyl consumption during open abdominal hysterectomy: a randomised controlled study |
| title_full | The effect of erector spinae plane block on fentanyl consumption during open abdominal hysterectomy: a randomised controlled study |
| title_fullStr | The effect of erector spinae plane block on fentanyl consumption during open abdominal hysterectomy: a randomised controlled study |
| title_full_unstemmed | The effect of erector spinae plane block on fentanyl consumption during open abdominal hysterectomy: a randomised controlled study |
| title_short | The effect of erector spinae plane block on fentanyl consumption during open abdominal hysterectomy: a randomised controlled study |
| title_sort | effect of erector spinae plane block on fentanyl consumption during open abdominal hysterectomy a randomised controlled study |
| topic | Fentanyl consumption Postoperative pain Abdominal hysterectomy Erector spinae plane block |
| url | https://doi.org/10.1186/s12871-023-02156-3 |
| work_keys_str_mv | AT mohamedahmedhamed theeffectoferectorspinaeplaneblockonfentanylconsumptionduringopenabdominalhysterectomyarandomisedcontrolledstudy AT magedlabibboules theeffectoferectorspinaeplaneblockonfentanylconsumptionduringopenabdominalhysterectomyarandomisedcontrolledstudy AT mohamedabdelmoniemmahmoud theeffectoferectorspinaeplaneblockonfentanylconsumptionduringopenabdominalhysterectomyarandomisedcontrolledstudy AT ranaahmedabdelghaffar theeffectoferectorspinaeplaneblockonfentanylconsumptionduringopenabdominalhysterectomyarandomisedcontrolledstudy AT mohamedahmedhamed effectoferectorspinaeplaneblockonfentanylconsumptionduringopenabdominalhysterectomyarandomisedcontrolledstudy AT magedlabibboules effectoferectorspinaeplaneblockonfentanylconsumptionduringopenabdominalhysterectomyarandomisedcontrolledstudy AT mohamedabdelmoniemmahmoud effectoferectorspinaeplaneblockonfentanylconsumptionduringopenabdominalhysterectomyarandomisedcontrolledstudy AT ranaahmedabdelghaffar effectoferectorspinaeplaneblockonfentanylconsumptionduringopenabdominalhysterectomyarandomisedcontrolledstudy |