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Ultrasound Guided Continuous Erector Spinae Plane Block versus Patient Controlled Analgesia in Open Nephrectomy for Renal Malignancies: A Randomized Controlled Study

BACKGROUND: It is critical to manage acute postoperative pain for patient satisfaction and better outcome. Erector spinae plane block (ESPB) can produce sensory blocking on both visceral and somatic levels. This study aimed to evaluate the ESPB efficacy in controlling acute postoperative pain in ope...

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Autores principales: Abdelgalil, Ahmed Salah, Ahmed, Ahmed Mansour, Gamal, Reham M, Elshal, Mamdouh Mahmoud, Bakeer, Ahmed Hussein, Shaker, Ehab Hanafy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531616/
https://www.ncbi.nlm.nih.gov/pubmed/36203788
http://dx.doi.org/10.2147/JPR.S379721
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author Abdelgalil, Ahmed Salah
Ahmed, Ahmed Mansour
Gamal, Reham M
Elshal, Mamdouh Mahmoud
Bakeer, Ahmed Hussein
Shaker, Ehab Hanafy
author_facet Abdelgalil, Ahmed Salah
Ahmed, Ahmed Mansour
Gamal, Reham M
Elshal, Mamdouh Mahmoud
Bakeer, Ahmed Hussein
Shaker, Ehab Hanafy
author_sort Abdelgalil, Ahmed Salah
collection PubMed
description BACKGROUND: It is critical to manage acute postoperative pain for patient satisfaction and better outcome. Erector spinae plane block (ESPB) can produce sensory blocking on both visceral and somatic levels. This study aimed to evaluate the ESPB efficacy in controlling acute postoperative pain in open nephrectomy for renal malignancies. METHODS: This prospective randomized, controlled, open-label trial included 60 cases scheduled for open nephrectomy for renal malignancy under general anesthesia. Cases were assigned randomly into two equal groups. Group E administered continuous preoperative unilateral ESPB (20mL bupivacaine 0.25% bolus then 6 mL/h 0.1% for 48 hours). Group C administered intravenous (IV) patient-controlled analgesia (PCA) morphine (0.01 mg/kg/h). Postoperative analgesia was managed by morphine (3 mg IV in group E or 0.01 mg/kg bolus with a 15-min lockout in group C) to keep the visual analog scale (VAS) scores <4. RESULTS: Intraoperative fentanyl consumption and total morphine consumption in 1st 48 hours postoperatively were significantly lower in group E than group C (P= 0.001 and <0.001, respectively). The time to first analgesic request was significantly longer in group E than group C (P <0.001). VAS scores at movement and rest were significantly lower in group E than group C (P <0.001). CONCLUSION: In renal malignancies, ESPB provided better analgesia with prolonged time and lower pain scores at both rest and movement compared to IV PCA following open nephrectomy.
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spelling pubmed-95316162022-10-05 Ultrasound Guided Continuous Erector Spinae Plane Block versus Patient Controlled Analgesia in Open Nephrectomy for Renal Malignancies: A Randomized Controlled Study Abdelgalil, Ahmed Salah Ahmed, Ahmed Mansour Gamal, Reham M Elshal, Mamdouh Mahmoud Bakeer, Ahmed Hussein Shaker, Ehab Hanafy J Pain Res Original Research BACKGROUND: It is critical to manage acute postoperative pain for patient satisfaction and better outcome. Erector spinae plane block (ESPB) can produce sensory blocking on both visceral and somatic levels. This study aimed to evaluate the ESPB efficacy in controlling acute postoperative pain in open nephrectomy for renal malignancies. METHODS: This prospective randomized, controlled, open-label trial included 60 cases scheduled for open nephrectomy for renal malignancy under general anesthesia. Cases were assigned randomly into two equal groups. Group E administered continuous preoperative unilateral ESPB (20mL bupivacaine 0.25% bolus then 6 mL/h 0.1% for 48 hours). Group C administered intravenous (IV) patient-controlled analgesia (PCA) morphine (0.01 mg/kg/h). Postoperative analgesia was managed by morphine (3 mg IV in group E or 0.01 mg/kg bolus with a 15-min lockout in group C) to keep the visual analog scale (VAS) scores <4. RESULTS: Intraoperative fentanyl consumption and total morphine consumption in 1st 48 hours postoperatively were significantly lower in group E than group C (P= 0.001 and <0.001, respectively). The time to first analgesic request was significantly longer in group E than group C (P <0.001). VAS scores at movement and rest were significantly lower in group E than group C (P <0.001). CONCLUSION: In renal malignancies, ESPB provided better analgesia with prolonged time and lower pain scores at both rest and movement compared to IV PCA following open nephrectomy. Dove 2022-09-30 /pmc/articles/PMC9531616/ /pubmed/36203788 http://dx.doi.org/10.2147/JPR.S379721 Text en © 2022 Abdelgalil et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Abdelgalil, Ahmed Salah
Ahmed, Ahmed Mansour
Gamal, Reham M
Elshal, Mamdouh Mahmoud
Bakeer, Ahmed Hussein
Shaker, Ehab Hanafy
Ultrasound Guided Continuous Erector Spinae Plane Block versus Patient Controlled Analgesia in Open Nephrectomy for Renal Malignancies: A Randomized Controlled Study
title Ultrasound Guided Continuous Erector Spinae Plane Block versus Patient Controlled Analgesia in Open Nephrectomy for Renal Malignancies: A Randomized Controlled Study
title_full Ultrasound Guided Continuous Erector Spinae Plane Block versus Patient Controlled Analgesia in Open Nephrectomy for Renal Malignancies: A Randomized Controlled Study
title_fullStr Ultrasound Guided Continuous Erector Spinae Plane Block versus Patient Controlled Analgesia in Open Nephrectomy for Renal Malignancies: A Randomized Controlled Study
title_full_unstemmed Ultrasound Guided Continuous Erector Spinae Plane Block versus Patient Controlled Analgesia in Open Nephrectomy for Renal Malignancies: A Randomized Controlled Study
title_short Ultrasound Guided Continuous Erector Spinae Plane Block versus Patient Controlled Analgesia in Open Nephrectomy for Renal Malignancies: A Randomized Controlled Study
title_sort ultrasound guided continuous erector spinae plane block versus patient controlled analgesia in open nephrectomy for renal malignancies: a randomized controlled study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531616/
https://www.ncbi.nlm.nih.gov/pubmed/36203788
http://dx.doi.org/10.2147/JPR.S379721
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