Bang YJ, Lee EK, Jeong H, Kang R, Ko JS, Hahm TS, Seong YJ, Lee YY, Jeong JS. Analgesic efficacy of erector spinae plane block in patients undergoing major gynecologic surgery: A randomized controlled study.
J Clin Anesth 2024;
93:111362. [PMID:
38150912 DOI:
10.1016/j.jclinane.2023.111362]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/18/2023] [Accepted: 12/13/2023] [Indexed: 12/29/2023]
Abstract
STUDY OBJECTIVE
To investigate the analgesic efficacy of erector spinae plane block (ESPB) in major gynecologic surgery, expressed as cumulative opioid consumption 24 h after surgery.
DESIGN
A single-center, patient-assessor blinded, randomized controlled study.
SETTING
Samsung medical center (tertiary university hospital), between February 2022 to January 2023.
PATIENTS
Eighty-eight females undergoing major surgery with long midline incision for gynecologic malignancy.
INTERVENTIONS
Patients were randomly assigned to receive standard systemic analgesia (Control group) or ESPB (ESPB group). ESPB was performed bilaterally at the level of the 9th thoracic vertebra with a mixture of 20 mL of 0.5% ropivacaine and 100 μg of epinephrine.
MEASUREMENTS
The primary outcome was cumulative opioid consumption at 24 h postoperatively. Secondary outcomes included opioid consumption and pain severity during the 72 h after surgery. The variables regarding postoperative recovery and patient-centered outcomes were compared.
MAIN RESULTS
The mean cumulative opioid consumption 24 h after surgery was 35.8 mg in the ESPB group, which was not significantly different from 41.4 mg in the control group (mean difference, 5.5 mg; 95% CI -1.7 to 12.8 mg; P = 0.128). However, patient satisfaction regarding analgesia was significantly higher in the ESPB group compared with the control group at 24 h postoperative (median difference, -1; 95% CI -3 to 0; P = 0.038). There were no significant differences in the variables associated with postoperative recovery.
CONCLUSION
ESPB did not reduce opioid consumption during the 24 h postoperative but attenuated pain intensity during the early period after surgery.
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