Ultrasound-guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy: Randomized, controlled trial
Laparoscopic cholecystectomy (LC) is a frequently applied minimally invasive surgery. Intraoperative access is provided with small keyhole entries on the abdominal wall. However, LC causes moderate to severe postoperative pain. The subcostal approach of TAP block was described by Hebbard et al. for...
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| Veröffentlicht in: | Journal of clinical anesthesia 2019-11, Vol.57, p.31-36 |
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| creator | Altıparmak, Başak Korkmaz Toker, Melike Uysal, Ali Ihsan Kuşçu, Yağmur Gümüş Demirbilek, Semra |
| description | Laparoscopic cholecystectomy (LC) is a frequently applied minimally invasive surgery. Intraoperative access is provided with small keyhole entries on the abdominal wall. However, LC causes moderate to severe postoperative pain. The subcostal approach of TAP block was described by Hebbard et al. for postoperative analgesia especially for upper abdominal surgeries. Ultrasound-guided erector spinae plane (US-ESP) block is a novel technique targeting ventral rami, dorsal rami and rami communicantes of the spinal nerves.
Single-blinded, prospective, randomized study.
Tertiary university hospital, postoperative recovery room and surgical ward.
Seventy-six patients (ASA I-II) were divided into two equal groups. After applying the exclusion criteria, 68 patients were included in final analysis (34 patients in ESP group and 34 in OSTAP group).
Erector spinae plane block was performed in the ESP group and oblique subcostal transversus abdominis block was performed in the OSTAP group.
Measurements: Postoperative tramadol consumption and pain scores between groups were compared. In addition, intraoperative fentanyl need was measured.
Postoperative tramadol consumption was 139.1 ± 21.9 mg in the ESP group and 199.4 ± 27.7 mg in the OSTAP group (mean difference 60.29 mg, 95% confidence interval - 72.40 to - 48.19; p |
| doi_str_mv | 10.1016/j.jclinane.2019.03.012 |
| format | Article |
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Single-blinded, prospective, randomized study.
Tertiary university hospital, postoperative recovery room and surgical ward.
Seventy-six patients (ASA I-II) were divided into two equal groups. After applying the exclusion criteria, 68 patients were included in final analysis (34 patients in ESP group and 34 in OSTAP group).
Erector spinae plane block was performed in the ESP group and oblique subcostal transversus abdominis block was performed in the OSTAP group.
Measurements: Postoperative tramadol consumption and pain scores between groups were compared. In addition, intraoperative fentanyl need was measured.
Postoperative tramadol consumption was 139.1 ± 21.9 mg in the ESP group and 199.4 ± 27.7 mg in the OSTAP group (mean difference 60.29 mg, 95% confidence interval - 72.40 to - 48.19; p < 0.001). NRS scores at almost all time-points were lower in the ESP group according to the repeated measures analysis. Integration of AUC and Mann Whitney U test results have revealed that there was no time wise difference between ESP and OSTAP groups even though NRS scores by itself and time-wise linear area under curve scores were higher in the OSTAP group compare to ESP group. There were no differences in intraoperative fentanyl need.
Ultrasound-guided ESP block reduced postoperative tramadol consumption and pain scores more effectively than OSTAP block after laparoscopic cholecystectomy surgery.
•Laparoscopic cholecystectomy causes moderate to severe postoperative pain.•OSTAP block provides analgesia especially for upper abdominal surgeries.•ESP is a novel block which extends cranially and caudally over several dermatomal levels.•Both ESP and OSTAP blocks are effective for analgesia after cholecystectomy.</description><identifier>ISSN: 0952-8180</identifier><identifier>EISSN: 1873-4529</identifier><identifier>DOI: 10.1016/j.jclinane.2019.03.012</identifier><identifier>PMID: 30851501</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abdomen ; Abdominal Muscles - innervation ; Adult ; Aged ; Analgesia ; Analgesics ; Analgesics, Opioid - administration & dosage ; Anesthesia ; Cholecystectomy ; Cholecystectomy, Laparoscopic - methods ; Erector spinae plane block ; Female ; Humans ; Intubation ; Laparoscopic cholecystectomy ; Laparoscopy ; Male ; Middle Aged ; Minimally invasive surgery ; Narcotics ; Nerve Block - methods ; Oblique subcostal transversus abdominis plane block ; Pain ; Pain Measurement ; Pain, Postoperative - prevention & control ; Paraspinal Muscles - innervation ; Patients ; Postoperative pain ; Prospective Studies ; Single-Blind Method ; Studies ; Surgery ; Time Factors ; Tramadol - administration & dosage ; Ultrasonic imaging ; Ultrasonography, Interventional - methods</subject><ispartof>Journal of clinical anesthesia, 2019-11, Vol.57, p.31-36</ispartof><rights>2019 Elsevier Inc.</rights><rights>Copyright © 2019 Elsevier Inc. All rights reserved.</rights><rights>2019. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c488t-40c0d238aff6fa61b38466dce80a740f3957a5928ab75da853f50941fd8015c73</citedby><cites>FETCH-LOGICAL-c488t-40c0d238aff6fa61b38466dce80a740f3957a5928ab75da853f50941fd8015c73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2266927547?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30851501$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Altıparmak, Başak</creatorcontrib><creatorcontrib>Korkmaz Toker, Melike</creatorcontrib><creatorcontrib>Uysal, Ali Ihsan</creatorcontrib><creatorcontrib>Kuşçu, Yağmur</creatorcontrib><creatorcontrib>Gümüş Demirbilek, Semra</creatorcontrib><title>Ultrasound-guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy: Randomized, controlled trial</title><title>Journal of clinical anesthesia</title><addtitle>J Clin Anesth</addtitle><description>Laparoscopic cholecystectomy (LC) is a frequently applied minimally invasive surgery. Intraoperative access is provided with small keyhole entries on the abdominal wall. However, LC causes moderate to severe postoperative pain. The subcostal approach of TAP block was described by Hebbard et al. for postoperative analgesia especially for upper abdominal surgeries. Ultrasound-guided erector spinae plane (US-ESP) block is a novel technique targeting ventral rami, dorsal rami and rami communicantes of the spinal nerves.
Single-blinded, prospective, randomized study.
Tertiary university hospital, postoperative recovery room and surgical ward.
Seventy-six patients (ASA I-II) were divided into two equal groups. After applying the exclusion criteria, 68 patients were included in final analysis (34 patients in ESP group and 34 in OSTAP group).
Erector spinae plane block was performed in the ESP group and oblique subcostal transversus abdominis block was performed in the OSTAP group.
Measurements: Postoperative tramadol consumption and pain scores between groups were compared. In addition, intraoperative fentanyl need was measured.
Postoperative tramadol consumption was 139.1 ± 21.9 mg in the ESP group and 199.4 ± 27.7 mg in the OSTAP group (mean difference 60.29 mg, 95% confidence interval - 72.40 to - 48.19; p < 0.001). NRS scores at almost all time-points were lower in the ESP group according to the repeated measures analysis. Integration of AUC and Mann Whitney U test results have revealed that there was no time wise difference between ESP and OSTAP groups even though NRS scores by itself and time-wise linear area under curve scores were higher in the OSTAP group compare to ESP group. There were no differences in intraoperative fentanyl need.
Ultrasound-guided ESP block reduced postoperative tramadol consumption and pain scores more effectively than OSTAP block after laparoscopic cholecystectomy surgery.
•Laparoscopic cholecystectomy causes moderate to severe postoperative pain.•OSTAP block provides analgesia especially for upper abdominal surgeries.•ESP is a novel block which extends cranially and caudally over several dermatomal levels.•Both ESP and OSTAP blocks are effective for analgesia after cholecystectomy.</description><subject>Abdomen</subject><subject>Abdominal Muscles - innervation</subject><subject>Adult</subject><subject>Aged</subject><subject>Analgesia</subject><subject>Analgesics</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Anesthesia</subject><subject>Cholecystectomy</subject><subject>Cholecystectomy, Laparoscopic - methods</subject><subject>Erector spinae plane block</subject><subject>Female</subject><subject>Humans</subject><subject>Intubation</subject><subject>Laparoscopic cholecystectomy</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Minimally invasive surgery</subject><subject>Narcotics</subject><subject>Nerve Block - methods</subject><subject>Oblique subcostal transversus abdominis plane block</subject><subject>Pain</subject><subject>Pain Measurement</subject><subject>Pain, Postoperative - prevention & control</subject><subject>Paraspinal Muscles - innervation</subject><subject>Patients</subject><subject>Postoperative pain</subject><subject>Prospective Studies</subject><subject>Single-Blind Method</subject><subject>Studies</subject><subject>Surgery</subject><subject>Time Factors</subject><subject>Tramadol - administration & dosage</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Interventional - methods</subject><issn>0952-8180</issn><issn>1873-4529</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkcFu1DAQhiMEotvCK1SWuHAgwU7ixOEEqiggVUJC9GxN7Mni4MTBdlZaXpWXwdFukeDCaQ7zzT8z_59l14wWjLLm9ViMypoZZixKyrqCVgVl5aNsx0Rb5TUvu8fZjna8zAUT9CK7DGGklKYGe5pdVFRwxinbZb_ubfQQ3DrrfL8ajZqgRxWdJ2FJ-kgWm5aQ3jr1nRzQhzUQ11vzY0US1l65EMGSpDGHcxd67SYzm_DX6JAUlwS7BT1Ec0ACM9g9BgPEDQT0aiNZUgfnGEg6B_3emXlPLCzgXVBuMYqob86iOoa4nTgd35AvMG_bfqJ-RZSbo3fWph-iN2CfZU8GsAGfn-tVdn_7_uvNx_zu84dPN-_uclULEfOaKqrLSsAwNAM0rK9E3TRaoaDQ1nSoOt4C70oBfcs1CF4NnHY1G7SgjKu2uspennQX75ItIcrJBIV2-96tQZZMdLwuhagT-uIfdHSrT0Ykqmyarmx5vQk2J0qlx4PHQS7eTOCPklG5xS9H-RC_3OKXtJIp_jR4fZZf-wn1n7GHvBPw9gRg8uNg0MugkuMKtdlSl9qZ_-34Df3My-g</recordid><startdate>20191101</startdate><enddate>20191101</enddate><creator>Altıparmak, Başak</creator><creator>Korkmaz Toker, Melike</creator><creator>Uysal, Ali Ihsan</creator><creator>Kuşçu, Yağmur</creator><creator>Gümüş Demirbilek, Semra</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20191101</creationdate><title>Ultrasound-guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy: Randomized, controlled trial</title><author>Altıparmak, Başak ; Korkmaz Toker, Melike ; Uysal, Ali Ihsan ; Kuşçu, Yağmur ; Gümüş Demirbilek, Semra</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c488t-40c0d238aff6fa61b38466dce80a740f3957a5928ab75da853f50941fd8015c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdomen</topic><topic>Abdominal Muscles - innervation</topic><topic>Adult</topic><topic>Aged</topic><topic>Analgesia</topic><topic>Analgesics</topic><topic>Analgesics, Opioid - administration & dosage</topic><topic>Anesthesia</topic><topic>Cholecystectomy</topic><topic>Cholecystectomy, Laparoscopic - methods</topic><topic>Erector spinae plane block</topic><topic>Female</topic><topic>Humans</topic><topic>Intubation</topic><topic>Laparoscopic cholecystectomy</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Minimally invasive surgery</topic><topic>Narcotics</topic><topic>Nerve Block - methods</topic><topic>Oblique subcostal transversus abdominis plane block</topic><topic>Pain</topic><topic>Pain Measurement</topic><topic>Pain, Postoperative - prevention & control</topic><topic>Paraspinal Muscles - innervation</topic><topic>Patients</topic><topic>Postoperative pain</topic><topic>Prospective Studies</topic><topic>Single-Blind Method</topic><topic>Studies</topic><topic>Surgery</topic><topic>Time Factors</topic><topic>Tramadol - administration & dosage</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography, Interventional - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Altıparmak, Başak</creatorcontrib><creatorcontrib>Korkmaz Toker, Melike</creatorcontrib><creatorcontrib>Uysal, Ali Ihsan</creatorcontrib><creatorcontrib>Kuşçu, Yağmur</creatorcontrib><creatorcontrib>Gümüş Demirbilek, Semra</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Altıparmak, Başak</au><au>Korkmaz Toker, Melike</au><au>Uysal, Ali Ihsan</au><au>Kuşçu, Yağmur</au><au>Gümüş Demirbilek, Semra</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ultrasound-guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy: Randomized, controlled trial</atitle><jtitle>Journal of clinical anesthesia</jtitle><addtitle>J Clin Anesth</addtitle><date>2019-11-01</date><risdate>2019</risdate><volume>57</volume><spage>31</spage><epage>36</epage><pages>31-36</pages><issn>0952-8180</issn><eissn>1873-4529</eissn><abstract>Laparoscopic cholecystectomy (LC) is a frequently applied minimally invasive surgery. Intraoperative access is provided with small keyhole entries on the abdominal wall. However, LC causes moderate to severe postoperative pain. The subcostal approach of TAP block was described by Hebbard et al. for postoperative analgesia especially for upper abdominal surgeries. Ultrasound-guided erector spinae plane (US-ESP) block is a novel technique targeting ventral rami, dorsal rami and rami communicantes of the spinal nerves.
Single-blinded, prospective, randomized study.
Tertiary university hospital, postoperative recovery room and surgical ward.
Seventy-six patients (ASA I-II) were divided into two equal groups. After applying the exclusion criteria, 68 patients were included in final analysis (34 patients in ESP group and 34 in OSTAP group).
Erector spinae plane block was performed in the ESP group and oblique subcostal transversus abdominis block was performed in the OSTAP group.
Measurements: Postoperative tramadol consumption and pain scores between groups were compared. In addition, intraoperative fentanyl need was measured.
Postoperative tramadol consumption was 139.1 ± 21.9 mg in the ESP group and 199.4 ± 27.7 mg in the OSTAP group (mean difference 60.29 mg, 95% confidence interval - 72.40 to - 48.19; p < 0.001). NRS scores at almost all time-points were lower in the ESP group according to the repeated measures analysis. Integration of AUC and Mann Whitney U test results have revealed that there was no time wise difference between ESP and OSTAP groups even though NRS scores by itself and time-wise linear area under curve scores were higher in the OSTAP group compare to ESP group. There were no differences in intraoperative fentanyl need.
Ultrasound-guided ESP block reduced postoperative tramadol consumption and pain scores more effectively than OSTAP block after laparoscopic cholecystectomy surgery.
•Laparoscopic cholecystectomy causes moderate to severe postoperative pain.•OSTAP block provides analgesia especially for upper abdominal surgeries.•ESP is a novel block which extends cranially and caudally over several dermatomal levels.•Both ESP and OSTAP blocks are effective for analgesia after cholecystectomy.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30851501</pmid><doi>10.1016/j.jclinane.2019.03.012</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Journal of clinical anesthesia, 2019-11, Vol.57, p.31-36 |
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| language | eng |
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| source | MEDLINE; Access via ScienceDirect (Elsevier); ProQuest Central |
| subjects | Abdomen Abdominal Muscles - innervation Adult Aged Analgesia Analgesics Analgesics, Opioid - administration & dosage Anesthesia Cholecystectomy Cholecystectomy, Laparoscopic - methods Erector spinae plane block Female Humans Intubation Laparoscopic cholecystectomy Laparoscopy Male Middle Aged Minimally invasive surgery Narcotics Nerve Block - methods Oblique subcostal transversus abdominis plane block Pain Pain Measurement Pain, Postoperative - prevention & control Paraspinal Muscles - innervation Patients Postoperative pain Prospective Studies Single-Blind Method Studies Surgery Time Factors Tramadol - administration & dosage Ultrasonic imaging Ultrasonography, Interventional - methods |
| title | Ultrasound-guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy: Randomized, controlled trial |
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