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Unilateral Right-Sided Ultrasound-Guided Erector Spinae Plane Block for Post-Laparoscopic Cholecystectomy Analgesia: A Randomized Control Trial

BACKGROUND: Post-laparoscopic cholecystectomy (LC) pain control is still an issue postoperatively. OBJECTIVES: We investigated the effectiveness of the unilateral right-side ultrasound-guided erector spinae plane block (ESPB) on post-LC pain intensity and opioid consumption. METHODS: This is a paral...

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Detalles Bibliográficos
Autores principales: Rahimzadeh, Poupak, Faiz, Seyed Hamid Reza, Salehi, Sajede, Imani, Farnad, Mueller, Ariel L., Sabouri, A. Sassan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Brieflands 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10016115/
https://www.ncbi.nlm.nih.gov/pubmed/36938107
http://dx.doi.org/10.5812/aapm-132152
Descripción
Sumario:BACKGROUND: Post-laparoscopic cholecystectomy (LC) pain control is still an issue postoperatively. OBJECTIVES: We investigated the effectiveness of the unilateral right-side ultrasound-guided erector spinae plane block (ESPB) on post-LC pain intensity and opioid consumption. METHODS: This is a parallel-arm randomized control trial on 62 adult patients with an American Society of Anesthesiologists (ASA) physical status ≤ 2 who underwent LC. The patients were randomized into 2 groups (the block group [BG] and the control group [CG]; n = 31 per group). BG received a single-shot right-sided T7 ESPB with 20 mL of 0.2% ropivacaine at arrival time in the post-anesthesia care unit (PACU). CG) received no regional anesthesia. Both groups received patient-controlled intravenous fentanyl and rescue meperidine for analgesia. The primary outcome was the pain intensity determined using a Numerical Rating Scale (NRS) in the first 24 hours after surgery. Secondary outcomes included total fentanyl and meperidine consumption within 24 hours. RESULTS: Median pain scores were significantly higher in CG at rest and with coughing up to 12 hours after surgery compared with BG. Pain scores were higher in CG with a cough at 24 hours compared with BG (median 1 [interquartile range (IQR) 1, 2] vs. 1 [1, 0]; P = 0.0005). Total fentanyl consumption and meperidine consumption within 24 hours were significantly lower in BG compared with CG (median 60 µg [IQR 60, 90] vs 250 µg [90, 300]; P < 0.0001 and median 20 µg [IQR 10, 20] vs 25 [20, 25]; P = 0.002, respectively). CONCLUSIONS: A single-shot, right-sided, unilateral ESPB decreases post-LC opioid consumption and pain.