Effect of postoperative erector spinae plane block as a rescue pain therapy in patients undergoing laparoscopic cholecystectomy: A historical cohort study
Hürü Ceren Gökduman, Taner Abdullah, İşbara Alp Enişte, Mert Canbaz, Funda Gümüş Özcan
Başakşehir Çam ve Sakura Şehir Hastanesi
Giriş: Laparoscopic cholecystectomy is a very common surgical procedure. In the postoperative period, it requires a well-planned analgesia management due to somatic and visceral pain components. The aim of this study is to evaluate the effect of erector spinae plane block (ESPB) as a rescue therapy in terms of opioid consumption and numeric rating scale (NRS) scores in patients who needed additional analgesics in the recovery room.
Gereç ve Yöntem: This study was designed as a single-center historical cohort study of consecutive patients who needed intervention for pain management in the postoperative anesthesia care unit (PACU).The pain intensity is evaluated with the NRS. If the NRS is > 3 meperidine bolus or ESPB is applied in line with the patients’ selection and the patients are evaluated until NRS < 4 is achieved. Five time points were determined for data recording: admission to PACU (T0), and 5th (T5), 15th (T15), 30th (T30) and 60th (T60) minutes in the PACU.
Bulgular: 108 patients were included in the statistical analysis. Sixty-two (57%) patients received ESPB postoperatively (pESPB) and 46 (43%) patients were managed with IV meperidine boluses only (IV). The cumulative meperidine doses administered were 0 (0-40) and 30 (10-80) mg for the pESPB and IV groups, respectively (p<0,001). NRS scores of group pESPB were significantly lower than those of group IV on T30 and T60. In the pESPB group 3 (4,8%) patients and in the IV group 9 (19,5%) patients had nausea at T60, this was statistically significant (p: 0,02).
Tartışma ve Sonuç: ESPB, when applied as a postoperative recue analgesic technique, reduces both the frequency of opioid administration and the amount of opioid administered in the early postoperative period. In patients without preoperative block, when postoperative rescue therapy is required, it should be considered before opioids.
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