Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.07.032
Brazilian Journal of Anesthesiology
Original Investigation

Evaluation of ultrasound-guided bilateral low thoracic erector spinae plane block for postoperative analgesia in cesarean delivery patients: a prospective, randomized, controlled clinical trial

Avaliação do bloqueio bilateral do plano eretor da coluna torácico baixo guiado por ultrassom para analgesia pós- -operatória em pacientes de cesariana: ensaio clínico prospectivo, randomizado e controlado

Hakan Aygun; Nilgun Kavrut Ozturk; Murside Ugur; Yeter Aydin; Gayem Inayet Celik; David Terence Thomas; Serkan Tulgar

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Abstract

Background
Erector spinae plane block (ESPB) is a recently described block. In many reports, ESPB has been reported to provide effective postoperative analgesia in patients undergoing cesarean delivery (CD). Herein, we compared the effectiveness of ESPB and control group in postoperative analgesia in patients undergoing CD under spinal anesthesia.

Methods
This assessor blinded, prospective, randomized, efficiency study was conducted in the postoperative recovery room and ward at a tertiary university hospital. Eighty-six patients (ASA II–III) were recruited. Following exclusion, 80 patients were randomized into two equal groups (block and control group). Standard multimodal analgesia was performed in the control group while ESPB block was performed in the intervention (ESPB) group. Opioid consumption was measured and pain intensity between groups was compared using Numeric Rating Scores (NRS).

Results
NRS was lower in Group ESPB at 3rd and 6th hours. There was no difference between NRS scores at other hours. Opioid consumption was lower in Group ESPB.

Conclusion
When added to multimodal analgesia, bilateral ultrasound guided low thoracic ESPB leads to improve the quality of analgesia in the first 24 hours in patients undergoing CD.

Keywords

Postoperative analgesia;  Erector spinae plane block;  Cesarean delivery

Resumo

Introdução: O bloqueio do plano eretor da espinha (BPEE) é um bloqueio recentemente descrito. Em muitos relatos, foi relatado que a BPEE fornece analgesia pós-operatória eficaz em pacientes submetidas ao parto cesáreo (PC). Aqui, comparamos a eficácia do BPEE e do grupo controle na analgesia pós-operatória em pacientes submetidos ao PC sob raquianestesia. Métodos: Este estudo avaliador cego, prospectivo, randomizado, de eficiência foi realizado na sala de recuperação pós-operatória e enfermaria de um hospital universitário terciário. Oitenta e seis pacientes (ASA II-III) foram recrutados. Após a exclusão, 80 pacientes foram randomizados em dois grupos iguais (grupo bloco e controle). A analgesia multimodal padrão foi realizada no grupo controle, enquanto o bloqueio BPEE foi realizado no grupo intervenção (BPEE). O consumo de opioides foi medido e a intensidade da dor entre os grupos foi comparada usando Numeric Rating Scores (NRS). Resultados: NRS foi menor no Grupo BPEE na 3ª e 6ª horas. Não houve diferença entre os escores do NRS em outras horas. O consumo de opioides foi menor no Grupo BPEE. Conclusão: Quando somada à analgesia multimodal, a BPEE torácica baixa bilateral guiada por ultrassom melhora a qualidade da analgesia nas primeiras 24 horas em pacientes submetidos ao PC.

Palavras-chave

Analgesia pósoperatória; Bloqueio do plano eretor da espinha; Cesariana

References

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