Ultrasound Guided Erector Spinae Plane Block Efficacy Following Open Gynecologic Oncology Surgery - A Prospective, Double Blinded, Randomized, Controlled Clinical Trial

Document Type : Original Article

Authors

1 Anesthesiology,Associate professor,Gujarat Cancer and Research Institute,Ahmedabad, Gujarat, India

2 Anesthesiology,Professor,Gujarat Cancer and Research institute,Ahmedabad,Gujarat,India

Abstract

Background: Erector spinae plane (ESP) block is a relatively novel block in which injection of local anesthetic deep to erector spinae muscle provides analgesia for thoracic and abdominal surgery. Regional analgesic technique decreases acute postoperative pain and opioid related side effects. The present study aimed to assess the efficacy of ESP block for postoperative analgesia following major open gynecologic oncology surgery.
Methods: Sixty female patients posted for gynecologic oncology surgeries were enrolled in this prospective, double blinded study and randomized to B and C group. In both groups, surgeries were done under general anesthesia, while group B patients received additional ultrasound guided bilateral ESP block at T9 level at the end of surgery. Primary outcome was time to first rescue analgesia. Secondary outcomes were 24 hours tramadol consumption, postoperative visual analog scale (VAS) scores and side effects. Chi square, student t tests and Mann Whitney U tests were used. P<0.05 was considered significant.
Results: Time to first rescue analgesia was prolonged in B group (10.10±2.40 hours) as compared to C group (1.38±1.21 hour) (P<0.0001) Total 24 hours tramadol consumption was less in B group (86±68.55mg) compared to C group (180±62.65mg). Postoperative pain scores were lower in B group compared to C group at rest and on movement also.
Conclusion: Ultrasound guided ESP block with general anesthesia provides superior postoperative analgesia compared to general anesthesia alone following major gynecologic oncology surgeries without any side effects.

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