Ultrasound-Guided Erector Spinae Plane Block ID and Thoracic Paravertebral Block for Postoperative Analgesia Management Following Video-Assisted Thoracic Surgery: A Prospective, Randomized, Controlled Study

Objective: Evaluation of the effectiveness of ultrasound (US)-guided erector spinae plane block (ESPB) and thoracic paravertebral block (TPVB) compared to no intervention control group for postoperative pain management in video assisted thoracic surgery (VATS) patients. Method: Three groups - Group ESPB, Group TPVB and the control group (n=30 per group) were included in this prospective, randomized, controlled study. The US-guided blocks were performed preoperatively in the ESPB and TPVB groups. Intravenous patient-controlled postoperative analgesia via fentanyl was administered in all of the patients. The patients were evaluated using visual analogue scale (VAS) scores, opioid consumption, and adverse events. Results: At all time intervals fentanyl consumption and VAS scores were significantly lower both in ESPB and TPVB groups compared to the control group (p

Video Yardımcılı Torakal Cerrahi Sonrası Postoperatif Analjezi Yönetimi için Ultrasonografi Rehberliğinde Yapılan Erektor Spina Plan Bloğu ve Torakal Paravertebral Blok Etkinliği: Prospektif, Randomize, Kontrollü Çalışma

Amaç: Video yardımcılı torakal cerrahi yapılan hastalarda postoperatif analjezi yönetimi için ultrasonografi (US) eşliğinde yapılan erektor spina plan bloğu (ESPB) ve torakal paravertebral bloğun (TPVB) kontrol grubuna göre etkinliğinin değerlendirilmesi amaçlanmıştır. Yöntem: Bu çalışmaya her grup için 30 hasta olmak üzere toplam 90 hasta dahil edilmiştir. Çalışma 3 gruptan oluşmaktadır; Grup ESPB, Grup TPVB ve Kontrol Grubu. ESPB ve TPVB gruplarındaki hastalara preoperatif olarak US eşliğinde blok yapıldı. Tüm gruplardaki hastalara fentanil içeren hasta kontrollü analjezi (HKA) uygulandı. Hastalar vizuel analog skala (VAS), opioid tüketimi ve yan etkiler kaydedilerek değerlendirildi. Bulgular: Tüm zaman aralıklarında fentanil tüketimi ve VAS Grup ESPB ve Grup TPVB de kontrol grubuna göre anlamlı olarak daha düşüktü (p

___

1. Agostini P, Lugg ST, Adams K et al. Postoperative pulmonary complications and rehabilitation requirements following lobectomy: a propensity score matched study of patients undergoing video-assisted thoracoscopic surgery versus thoracotomy. Interactive Cardiovascular and Thoracic Surgery. 2017;24:931-7. https://doi.org/10.1093/icvts/ivx002

2. Desai H, Natt B, Kim S, Bime C. Decreased in-hospital mortality after lobectomy using video-assisted thoracoscopic surgery compared with open thoracotomy. Annals of the American Thoracic Society. 2017;14:262-6. https://doi.org/10.1513/AnnalsATS.201606-429OC

3. Umari M, Carpanese V, Moro V et al. Postoperative analgesia after pulmonary resection with a focus on video-assisted thoracoscopic surgery. European Journal of Cardio-Thoracic Surgery. 2017;53:932-8. https://doi.org/10.1093/ejcts/ezx413

4. Ciftci B, Ekinci M, Celik EC et al. Efficacy of an Ultrasound-Guided Erector Spinae Plane Block for Postoperative Analgesia Management After Video- Assisted Thoracic Surgery: A Prospective Randomized Study. Journal of Cardiothoracic and Vascular Anesthesia. 2019;00:1-6. https://doi.org/10.1053/j.jvca.2019.04.026

5. Davies RG, Myles PS, Graham JM. A comparison of the analgesic efficacy and side-effects of paravertebral vs epidural blockade for thoracotomy-a systematic review and meta-analysis of randomized trials. BJA: British Journal of Anaesthesia. 2006;96:418-26. https://doi.org/10.1093/bja/ael020

6. Conlon NP, Shaw AD, Grichnik KP. Postthoracotomy paravertebral analgesia: will it replace epidural analgesia?. Anesthesiology Clinics. 2008;26:369-80. https://doi.org/10.1016/j.anclin.2008.01.003

7. Komatsu T, Kino A, Inoue M et al. Paravertebral block for video-assisted thoracoscopic surgery: analgesic effectiveness and role in fast-track surgery. International Journal of Surgery. 2014;12:936-9. https://doi.org/10.1016/j.ijsu.2014.07.272

8. Okajima H, Tanaka O, Ushio M et al. Ultrasound-guided continuous thoracic paravertebral block provides comparable analgesia and fewer episodes of hypotension than continuous epidural block after lung surgery. Journal of Anesthesia. 2015;29:373-8. https://doi.org/10.1007/s00540-014-1947-y

9. Naja Z, Lönnqvist PA. Somatic paravertebral nerve blockade incidence of failed block and complications. Anaesthesia. 2001;56:1181-1201. https://doi.org/10.1111/j.1365-2044.2001.2084-2.x

10. Song L, Zhou Y, Huang D. Inadvertent posterior intercostal artery puncture and haemorrhage after ultrasound-guided thoracic paravertebral block: a case report. BMC Anesthesiology. 2018;18:196. https://doi.org/10.1186/s12871-018-0667-5

11. Wilson JM, Lohser J, Klaibert B. Erector spinae plane block for postoperative rescue analgesia in thoracoscopic surgery. Journal of Cardiothoracic and Vascular Anesthesia. 2018;32:e5-e7. https://doi.org/10.1053/j.jvca.2018.06.026

12. Luis-Navarro JC, Seda-Guzmán M, Luis-Moreno C, López-Romero JL. The erector spinae plane block in 4 cases of video-assisted thoracic surgery. Revista Española de Anestesiología y Reanimación (English Edition). 2018;65:204-8. https://doi.org/10.1016/j.redare.2018.02.002

13. Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The erector spinaeplane block: a novelan algesic technique in thoracic neuropathic pain. Reg Anesth Pain Med. 2016;41:621-7. https://doi.org/10.1097/AAP.0000000000000451

14. Chin KJ, Adhikary SD, Forero M. Erector Spinae Plane (ESP) Block: a New Paradigm in Regional Anesthesia and Analgesia. Current Anesthesiology Reports. 2019;1-10. https://doi.org/10.1007/s40140-019-00333-0

15. Yayik AM, Cesur S, Ozturk F, et al. Postoperative Analgesic Efficacy of the Ultrasound-Guided Erector Spinae Plane Block in PatientsUndergoing Lumbar Spinal Decompression Surgery: A Randomized Controlled Study. World Neurosurgery. 2019;126:779- 85. https://doi.org/10.1016/j.wneu.2019.02.149

16. Ahiskalioglu A, Tulgar S, Celik M, Ozer Z, Alici HA, Aydin ME. Lumbar Erector Spinae Plane Block as a Main Anesthetic Method for Hip Surgery in High Risk Elderly Patients: Initial Experience with a Magnetic Resonance Imaging. Eurasian J Med. 2020;52:16-20. https://doi.org/10.5152/eurasianjmed.2020.19224

17. Tulgar S, Ahiskalioglu A, De Cassai A, Gurkan Y. Efficacy of bilateral erector spinae plane block in the management of pain: current insights. J Pain Res. 2019;12:2597- 2613. Published 2019 Aug 27. https://doi.org/10.2147/JPR.S182128

18. Altiparmak B, Toker MK, Uysal Aİ, Kuşçu Y, Demirbilek SG. Eficácia do bloqueio do plano do músculo eretor da espinha guiado por ultrassom para analgesia após colecistectomia laparoscópica: um estudo controlado randômico [Efficacy of ultrasound-guided erector spinae plane block for analgesia after laparoscopic cholecystectomy: a randomized controlled trial]. Rev Bras Anestesiol. 2019;69:561-8. https://doi.org/10.1016/j.bjan.2019.09.001

19. Yang HM, Choi YJ, Kwon HJ et al. Comparison of injectate spread and nerve involvement between retrolaminar and erector spinae plane blocks in the thoracic region: a cadaveric study. Anaesthesia. 2018;73:1244-50. https://doi.org/10.1111/anae.14408

20. Costache I, Pawa A, Abdallah FW. Paravertebral by proxy-time to redefine the paravertebral block. Anaesthesia. 2018;73:1185-8. https://doi.org/10.1111/anae.14348

21. Greenhalgh K, Womack J, Marcangelo S. Injectate spread in erector spinae plane block. Anaesthesia. 2019;74:126-7. https://doi.org/10.1111/anae.14523

22. Adhikary SD, Bernard S, Lopez H, Chin KJ. Erector spinae plane block versus retrolaminar block: a magnetic resonance imaging and anatomical study. Reg Anesth Pain Med. 2018;43:756-62. https://doi.org/10.1097/AAP.0000000000000798

23. Ivanusic J, Konishi Y, Barrington MJ. A cadaveric study investigating the mechanism of action of erector spinae blockade. Reg Anesth Pain Med. 2018; 43:567-71. https://doi.org/10.1097/AAP.0000000000000789

24. Muñoz F, Cubillos J, Bonilla AJ, Chin KJ. Erector spinae plane block for postoperative analgesia in pediatric oncological thoracic surgery. Canadian Journal of Anesthesia Journal canadiend’anesthésie. 2017;64:880-2. https://doi.org/10.1007/s12630-017-0894-0

25. Forero M, Rajarathinam M, Adhikary S, Chin KJ. Continuous erector spinae plane block for rescue analgesia in thoracotomy after epidural failure: a case report. A&A Practice. 2017;8:254-6. https://doi.org/10.1213/XAA.0000000000000478

26. Raft J, Chin KJ, Belanger ME et al. Continuous Erector Spinae Plane Block for thoracotomy analgesia after epidural failure. Journal of Clinical Anesthesia. 2018;54:132. https://doi.org/10.1016/j.jclinane.2018.10.024

27. Ciftci B, Ekinci M, Demiraran Y. Ultrasound-guided single-shot preemptive erector spinae plane block for postoperative pain management. Journal of Cardiothoracic and Vascular Anesthesia. 2019;33:1175-6. https://doi.org/10.1053/j.jvca.2018.10.040

28. Hernandez MA, Palazzi L, Lapalma J et al. Erector spinae plane block for surgery of the posterior thoracic wall in a pediatric patient. Regional Anesthesia & Pain Medicine. 2018;43:217-9. https://doi.org/10.1097/AAP.0000000000000716

29. Adhikary SD, Pruett A, Forero M, Thiruvenkatarajan V. Erector spinae plane block as an alternative to epidural analgesia for post-operative analgesia following videoassisted thoracoscopic surgery: a case study and a literature review on the spread of local anaesthetic in the erector spinae plane. Indian Journal of Anaesthesia. 2018;62:75. https://doi.org/10.4103/ija.IJA_693_17

30. Gürkan Y, Aksu C, Kuş A et al. Ultrasound guided erector spinae plane block reduces postoperative opioid consumption following breast surgery: a randomized controlled study. Journal of Clinical Anesthesia. 2018;50:65-8. https://doi.org/10.1016/j.jclinane.2018.06.033

31. Chen N, Qiao Q, Chen R et al. The effect of ultrasoundguided intercostal nerve block, single-injection erector spinae plane block and multiple-injection paravertebral block on postoperative analgesia in thoracoscopic surgery: A randomized, double-blinded, clinical trial. Journal of clinical anesthesia. Ahead of print. https://doi.org/10.1016/j.jclinane.2019.07.002

32. Fang B, Wang Z, Huang X. Ultrasound-guided preoperative single-dose erector spinae plane block provides comparable analgesia to thoracic paravertebral block following thoracotomy: a single center randomized controlled double-blind study. Annals of Translational Medicine. 2019;7:174. https://doi.org/10.21037/atm.2019.03.53

33. Schwartzmann A, Peng P, Maciel MA, Forero M. Mechanism of the erector spinae plane block: insights from a magnetic resonance imaging study. Canadian Journal of Anesthesia/Journal Canadiend’ Anesthésie. 2018;65:1165-6. https://doi.org/10.1007/s12630-018-1187-y
Anestezi Dergisi-Cover
  • ISSN: 1300-0578
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1993
  • Yayıncı: Betül Kartal
Sayıdaki Diğer Makaleler

Efficacy of Ultrasound-Guided Erector Spinae ID Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy: A Retrospective Cohort Study

Ömer KARACA, Hüseyin Ulaş PINAR

Prone Positioning in Emergency Surgery During COVID-19

Rashmi RAMACHANDRAN, Sanjeeb GİRİ, Abhishek SİNGH

Video Yardımcılı Torakal Cerrahi Sonrası Postoperatif Analjezi Yönetimi için Ultrasonografi Rehberliğinde Yapılan Erektor Spina Plan Bloğu ve Torakal Paravertebral Blok Etkinliği: Prospektif, Randomize, Kontrollü Çalışma

Mürsel EKİNCİ, Bahadır ÇİFTÇİ, Erkan Cem ÇELİK, Yunus Oktay ATALAY, Mehmet Zeki GÜNLÜOĞLU, İsmail Cem TUKAC, Birzat Emre GÖLBOYU

Möebius Syndrome, What Anesthesiologist ID Should Consider About: A Case Report

Masoud NASHİBİ, Parisa SEZARİ, Farhad SAFARİ, Ahmad NADERİ, Kamran MOTTAGHİ

Möebius Sendromu, Anestezi Uzmanının Nelere Dikkat Etmesi Gerekir: Olgu Sunumu

Masoud NASHİBİ, Parisa SEZARİ, Farhad SAFARİ, Ahmad NADERİ, Kamran MOTTAGHİ

COVID-19 Tanılı ya da Şüpheli Hastaların ID Preoperatif Hazırlığı ve Ameliyathane Yönetimi

Hatice TÜRE, Şüheda ÇELEBİ, Ezgi AYTAÇ, Ayşe TUĞLUĞLU KUŞDEMİR, Birsel EKİCİ, Abdulvahap OĞUZ, Tuğhan UTKU, Ferdi MENDA, Meral SÖNMEZOĞLU

Prone Positioning in Emergency Surgery During COVID-19

Sanjeeb GİRİ, Abhishek SİNGH, Rashmi RAMACHANDRAN

The Value of SCUBE-1 on Ischemia-Reperfusion ID Model in Diabetic Patients During Knee Replacement Surgery

Savaş ALTINSOY, Başak GÜLEL, Derya ÖZKAN, Ali YALÇINDAĞ, Lütfiye Tuba HANCI, Aslı DÖNMEZ

Fiberoptik Bronkoskopi Rehberliğinde veya Kör ID Açılan Perkutan Trakeostomi İşleminin Genel Yoğun Bakım Ünitelerinde Kıyaslanması

Zerrin ÖZÇELK, Yücel GÜLTEKİN

Sezaryende Uygulanan Anestezi Tekniklerinin ID ve Yenidoğan Apgar Skoru Üzerine Etkili Faktörlerin Retrospektif Analizi: İlçe Devlet Hastanesi Örneği

Selda KAYAALTI