Comparative retrospective review of perioperative analgesia using ultrasound-guided programmed intermittent erector spinae plane block for video-assisted thoracoscopic lobectomy
Abstract Background The retrospective cohort study was conducted to estimate the opioid-sparing anesthesia and limited side-effects with ultrasound (US)-guided ESPB using programmed intermittent bolus (PIB) or continuous infusion (CI) and standard opioid-based anesthesia in patients undergoing video...
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-023-02338-z |
| _version_ | 1827764256386318336 |
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| author | Xuefang Zhu Wei Ye Jinhong Chen Jiwen Xiao Weibing Zhao |
| author_facet | Xuefang Zhu Wei Ye Jinhong Chen Jiwen Xiao Weibing Zhao |
| author_sort | Xuefang Zhu |
| collection | DOAJ |
| description | Abstract Background The retrospective cohort study was conducted to estimate the opioid-sparing anesthesia and limited side-effects with ultrasound (US)-guided ESPB using programmed intermittent bolus (PIB) or continuous infusion (CI) and standard opioid-based anesthesia in patients undergoing video-assisted thoracoscopic lobectomy (VATS). Methods Patients underwent VATS were stratified into either control group or one of the two ESPB groups in a 1:2:2 ratio depending on whether PIB was implemented or not. The primary endpoint was intra- and post-operative opioids consumption over the first 48 h following surgery. Results A total of 180 cases were included in the analysis. Cumulative perioperative opioid administration was found to be significantly different between PIB, CI and control group (both p < 0.001), and between PIB and CI group (p = 0.028). More specifically, the mean was 305.30 ± 51.35 mg, 339.68 ± 56.07 mg and 468.91 ± 79.84 mg in PIB, CI and control group. NRS scores at rest across all postoperative times were comparable in two ESPB groups, while significantly lower than control group, however, scores during exercising at postoperative 3, 6, 12 h were significantly lower in PIB group as compared to CI group. A wider anesthetized dermatomes with PIB was observed at 6, 24 and 48 h as opposed to the CI. The mean of levobupivacaine plasma concentration was significantly lower for PIB at postoperative 0.5, 12, 24 and 48 h after initiation than CI. However, local anesthetic toxicity was not observed in any of the two ESPB groups. Conclusions When US-guided ESPB using PIB was performed preoperatively, it contributed to the minimization of intra- and post-operative opioid consumption due to better analgesia with a wider anesthetic dermatome opposed to conventional CI, whereas, it was also associated with lower risk of local anesthetic toxicity because of lower plasma concentration of levobupivacaine. |
| first_indexed | 2024-03-11T11:01:46Z |
| format | Article |
| id | doaj.art-fef1a92ed0104443b4455f22afd3498b |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-03-11T11:01:46Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-fef1a92ed0104443b4455f22afd3498b2023-11-12T12:28:12ZengBMCBMC Anesthesiology1471-22532023-11-0123111110.1186/s12871-023-02338-zComparative retrospective review of perioperative analgesia using ultrasound-guided programmed intermittent erector spinae plane block for video-assisted thoracoscopic lobectomyXuefang Zhu0Wei Ye1Jinhong Chen2Jiwen Xiao3Weibing Zhao4Department of Anesthesiology, The Fifth People’s Hospital of Huan’anDepartment of Anesthesiology, The Fifth People’s Hospital of Huan’anDepartment of Anesthesiology, The Fifth People’s Hospital of Huan’anDepartment of Anesthesiology, The Fifth People’s Hospital of Huan’anDepartment of Anesthesiology, The Fifth People’s Hospital of Huan’anAbstract Background The retrospective cohort study was conducted to estimate the opioid-sparing anesthesia and limited side-effects with ultrasound (US)-guided ESPB using programmed intermittent bolus (PIB) or continuous infusion (CI) and standard opioid-based anesthesia in patients undergoing video-assisted thoracoscopic lobectomy (VATS). Methods Patients underwent VATS were stratified into either control group or one of the two ESPB groups in a 1:2:2 ratio depending on whether PIB was implemented or not. The primary endpoint was intra- and post-operative opioids consumption over the first 48 h following surgery. Results A total of 180 cases were included in the analysis. Cumulative perioperative opioid administration was found to be significantly different between PIB, CI and control group (both p < 0.001), and between PIB and CI group (p = 0.028). More specifically, the mean was 305.30 ± 51.35 mg, 339.68 ± 56.07 mg and 468.91 ± 79.84 mg in PIB, CI and control group. NRS scores at rest across all postoperative times were comparable in two ESPB groups, while significantly lower than control group, however, scores during exercising at postoperative 3, 6, 12 h were significantly lower in PIB group as compared to CI group. A wider anesthetized dermatomes with PIB was observed at 6, 24 and 48 h as opposed to the CI. The mean of levobupivacaine plasma concentration was significantly lower for PIB at postoperative 0.5, 12, 24 and 48 h after initiation than CI. However, local anesthetic toxicity was not observed in any of the two ESPB groups. Conclusions When US-guided ESPB using PIB was performed preoperatively, it contributed to the minimization of intra- and post-operative opioid consumption due to better analgesia with a wider anesthetic dermatome opposed to conventional CI, whereas, it was also associated with lower risk of local anesthetic toxicity because of lower plasma concentration of levobupivacaine.https://doi.org/10.1186/s12871-023-02338-zErector spinae plane blockPerioperative analgesiaProgrammed intermittent bolusContinuous infusionVideo-assisted thoracoscopic lobectomyPostoperative recovery quality |
| spellingShingle | Xuefang Zhu Wei Ye Jinhong Chen Jiwen Xiao Weibing Zhao Comparative retrospective review of perioperative analgesia using ultrasound-guided programmed intermittent erector spinae plane block for video-assisted thoracoscopic lobectomy BMC Anesthesiology Erector spinae plane block Perioperative analgesia Programmed intermittent bolus Continuous infusion Video-assisted thoracoscopic lobectomy Postoperative recovery quality |
| title | Comparative retrospective review of perioperative analgesia using ultrasound-guided programmed intermittent erector spinae plane block for video-assisted thoracoscopic lobectomy |
| title_full | Comparative retrospective review of perioperative analgesia using ultrasound-guided programmed intermittent erector spinae plane block for video-assisted thoracoscopic lobectomy |
| title_fullStr | Comparative retrospective review of perioperative analgesia using ultrasound-guided programmed intermittent erector spinae plane block for video-assisted thoracoscopic lobectomy |
| title_full_unstemmed | Comparative retrospective review of perioperative analgesia using ultrasound-guided programmed intermittent erector spinae plane block for video-assisted thoracoscopic lobectomy |
| title_short | Comparative retrospective review of perioperative analgesia using ultrasound-guided programmed intermittent erector spinae plane block for video-assisted thoracoscopic lobectomy |
| title_sort | comparative retrospective review of perioperative analgesia using ultrasound guided programmed intermittent erector spinae plane block for video assisted thoracoscopic lobectomy |
| topic | Erector spinae plane block Perioperative analgesia Programmed intermittent bolus Continuous infusion Video-assisted thoracoscopic lobectomy Postoperative recovery quality |
| url | https://doi.org/10.1186/s12871-023-02338-z |
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