Ultrasound-guided erector spinae plane block for pain management after gastrectomy: a randomized, single-blinded, controlled trial

Heejoon Jeong; Ji Won Choi; Woo Seog Sim; Duk Kyung Kim; Yu Jeong Bang; Soyoon Park; Hyean Yeo; Hara Kim

doi:10.3344/kjp.2022.35.3.303

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자료유형: 학술저널

저자정보: Heejoon Jeong (Sungkyunkwan University School of Medicine) Ji Won Choi (Sungkyunkwan University School of Medicine) Woo Seog Sim (Sungkyunkwan University School of Medicine) Duk Kyung Kim (Sungkyunkwan University School of Medicine) Yu Jeong Bang (Sungkyunkwan University School of Medicine) Soyoon Park (Sungkyunkwan University School of Medicine) Hyean Yeo (Sungkyunkwan University School of Medicine) Hara Kim (Sungkyunkwan University School of Medicine)

저널정보: 대한통증학회 The Korean Journal of Pain The Korean Journal of Pain 제35권 제3호

발행연도: 2022.7

수록면: 303 - 310 (8page)

DOI: 10.3344/kjp.2022.35.3.303

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Background: Open gastrectomy causes severe postoperative pain. Therefore, we investigated the opioid-sparing effect of the ultrasound-guided bilateral erector spinae plane block (ESPB) after open gastrectomy. Methods: Adult patients undergoing open gastrectomy were randomly assigned to either the ESPB group (ESPB + fentanyl based intravenous patient-controlled analgesia [IV-PCA]) or a control group (fentanyl based IV-PCA only). The primary outcome was total fentanyl equivalent consumption during the first 24 hour postoperatively. Secondary outcomes were pain intensities using a numeric rating scale at the postanesthesia care unit (PACU) and at 3, 6, 12, and 24 hour postoperatively, and the amount of fentanyl equivalent consumption during the PACU stay and at 3, 6, and 12 hour postoperatively, and the time to the first request for rescue analgesia. Results: Fifty-eight patients were included in the analysis. There was no significant difference in total fentanyl equivalent consumption during the first 24 hour postoperatively between the two groups (P = 0.471). Pain intensities were not significantly different between the groups except during the PACU stay and 3 hour postoperatively (P < 0.001, for both). Time to the first rescue analgesia in the ward was longer in the ESPB group than the control group (P = 0.045). Conclusions: Ultrasound-guided ESPB did not decrease total fentanyl equivalent consumption during the first 24 hour after open gastrectomy. It only reduced postoperative pain intensity until 3 hour postoperatively compared with the control group. Ultrasound-guided single-shot ESPB cannot provide an efficient opioid-sparing effect after open gastrectomy.

#Analgesia #Patient-Controlled #Analgesics #Opioid #Fentanyl #Gastrectomy #Nerve Block #Nociceptive Pain #Pain Management #Pain #Postoperative #Ultrasonography #Interventional.

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