Role of erector spinae plane block in transjugular intrahepatic portosystemic shunt procedure: A randomized controlled trial
ABSTRACTBackground Anesthesia for transjugular intrahepatic portosystemic shunt (TIPS) for lowering raised portal pressure is clinically challenging. As patients, candidates for TIPS are medically complex due to chronic liver disease, adding to remote area anesthesia’s complexities. Multimodal analg...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2023.2261700 |
| _version_ | 1797671436373983232 |
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| author | Minatallah A. Elshafie Mohamed S. Alwarraky Nagwa I. Mowafy Maha L. Elsheikh Amin M. Alansary |
| author_facet | Minatallah A. Elshafie Mohamed S. Alwarraky Nagwa I. Mowafy Maha L. Elsheikh Amin M. Alansary |
| author_sort | Minatallah A. Elshafie |
| collection | DOAJ |
| description | ABSTRACTBackground Anesthesia for transjugular intrahepatic portosystemic shunt (TIPS) for lowering raised portal pressure is clinically challenging. As patients, candidates for TIPS are medically complex due to chronic liver disease, adding to remote area anesthesia’s complexities. Multimodal analgesia, including erector spinae plane block (ESPB), can improve anesthesia quality with patient satisfaction.Methods Fifty-six patients scheduled for TIPS, aged 18–60 years and with Child classification A or B, were randomly allocated into two groups. The ESPB group experienced ESPB (n = 24), while the control group was introduced with sedation spontaneously breathing (n = 24). Primarily, we investigated the records of the hemodynamic profile and analgesia nociceptive index (ANI). As a secondary aim, we recorded the opioid consumption, complication incidence, and patient and interventional radiologist satisfaction scores.Results Heart rate was significantly lower in the ESPB group at the beginning of the procedure, liver puncture, and balloon dilatation events, while there were no significant differences in mean blood pressure. Analgesia assessment by ANI was significantly higher in the ESPB group indicating adequate analgesia. Opioid consumption was significantly lower in the ESPB group than in the control group. Statistical analysis for patient satisfaction showed better results in the ESPB group, while the surgeon satisfaction score showed no significant statistical differences.Conclusion ESPB could be recommended as an alternative to analgesia in TIPS and its vulnerable patients to improve safety by reducing sedation-related morbidity and complications with improving the patient’s degree of satisfaction. |
| first_indexed | 2024-03-11T21:14:23Z |
| format | Article |
| id | doaj.art-f7cd21342ebe4610a9af51c0faab1228 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-03-11T21:14:23Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-f7cd21342ebe4610a9af51c0faab12282023-09-29T05:26:15ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492023-12-0139181081810.1080/11101849.2023.2261700Role of erector spinae plane block in transjugular intrahepatic portosystemic shunt procedure: A randomized controlled trialMinatallah A. Elshafie0Mohamed S. Alwarraky1Nagwa I. Mowafy2Maha L. Elsheikh3Amin M. Alansary4Department of Anesthesia and Intensive Care, National Liver Institute, Menoufia University, Shebeen Elkom, EgyptDepartment of Diagnostic and interventional medical imaging, National Liver Institute, Menoufia University, Shebeen Elkom, EgyptDepartment of Anesthesia and Intensive Care, National Liver Institute, Menoufia University, Shebeen Elkom, EgyptDepartment of Anesthesia and Intensive Care, National Liver Institute, Menoufia University, Shebeen Elkom, EgyptDepartment of Anesthesia, Intensive Care and pain management, Faculty of Medicine, Ain-Shams University, Cairo, EgyptABSTRACTBackground Anesthesia for transjugular intrahepatic portosystemic shunt (TIPS) for lowering raised portal pressure is clinically challenging. As patients, candidates for TIPS are medically complex due to chronic liver disease, adding to remote area anesthesia’s complexities. Multimodal analgesia, including erector spinae plane block (ESPB), can improve anesthesia quality with patient satisfaction.Methods Fifty-six patients scheduled for TIPS, aged 18–60 years and with Child classification A or B, were randomly allocated into two groups. The ESPB group experienced ESPB (n = 24), while the control group was introduced with sedation spontaneously breathing (n = 24). Primarily, we investigated the records of the hemodynamic profile and analgesia nociceptive index (ANI). As a secondary aim, we recorded the opioid consumption, complication incidence, and patient and interventional radiologist satisfaction scores.Results Heart rate was significantly lower in the ESPB group at the beginning of the procedure, liver puncture, and balloon dilatation events, while there were no significant differences in mean blood pressure. Analgesia assessment by ANI was significantly higher in the ESPB group indicating adequate analgesia. Opioid consumption was significantly lower in the ESPB group than in the control group. Statistical analysis for patient satisfaction showed better results in the ESPB group, while the surgeon satisfaction score showed no significant statistical differences.Conclusion ESPB could be recommended as an alternative to analgesia in TIPS and its vulnerable patients to improve safety by reducing sedation-related morbidity and complications with improving the patient’s degree of satisfaction.https://www.tandfonline.com/doi/10.1080/11101849.2023.2261700AnalgesiaErector spinae blockTransjugular intrahepatic portosystemic shuntUltrasonography |
| spellingShingle | Minatallah A. Elshafie Mohamed S. Alwarraky Nagwa I. Mowafy Maha L. Elsheikh Amin M. Alansary Role of erector spinae plane block in transjugular intrahepatic portosystemic shunt procedure: A randomized controlled trial Egyptian Journal of Anaesthesia Analgesia Erector spinae block Transjugular intrahepatic portosystemic shunt Ultrasonography |
| title | Role of erector spinae plane block in transjugular intrahepatic portosystemic shunt procedure: A randomized controlled trial |
| title_full | Role of erector spinae plane block in transjugular intrahepatic portosystemic shunt procedure: A randomized controlled trial |
| title_fullStr | Role of erector spinae plane block in transjugular intrahepatic portosystemic shunt procedure: A randomized controlled trial |
| title_full_unstemmed | Role of erector spinae plane block in transjugular intrahepatic portosystemic shunt procedure: A randomized controlled trial |
| title_short | Role of erector spinae plane block in transjugular intrahepatic portosystemic shunt procedure: A randomized controlled trial |
| title_sort | role of erector spinae plane block in transjugular intrahepatic portosystemic shunt procedure a randomized controlled trial |
| topic | Analgesia Erector spinae block Transjugular intrahepatic portosystemic shunt Ultrasonography |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2023.2261700 |
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