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Wu S, Wu J, Zhang X. Application of an ultrasound-guided bilateral erector spinae plane block after the Nuss procedure for pectus excavatum in children: a retrospective cohort study with propensity score matching. Front Pediatr 2023; 11:1201604. [PMID: 37449266 PMCID: PMC10336535 DOI: 10.3389/fped.2023.1201604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Objective To retrospectively analyze the effect of applying an ultrasound-guided bilateral erector spine plane block (ESPB) after the Nuss procedure for surgical repair of pectus excavatum (PE) in children. Methods The subjects of the study were patients with severe PE who received the Nuss procedure in our hospital between 1 January 2019 and 30 November 2021. According to different methods for postoperative pain management, the enrolled patients were divided into two groups, the ultrasound-guided ESPB group and the thoracic epidural analgesia (TEA) group. The primary outcome of this study was analgesic drug dosage and the secondary outcome was numerical rating scales (NRSs) between the two groups. Results There was no significant difference between the two groups in terms of demographic, preoperative clinical evaluation, or surgical characteristics (P > 0.05). The catheter duration in the TEA group was significantly shorter than that in the ESPB group (P < 0.05), while the hospitalization time in the ESPB group was significantly shorter than that in the TEA group (P < 0.05). In terms of oral morphine equivalent comparison, the required dose of the TEA group was lower than that of the ESPB group on the 1st and 2nd day after the operation (P < 0.05), and there was no statistical difference between the two groups on the 3rd and 4th day after the operation (P > 0.05). The number of patients with an S-NRS ≥ 7 and D-NRS ≥ 7 in the TEA group at day 1 was lower than that in the ESPB group (P < 0.05). There was no significant difference between the two groups at other time points (P > 0.05). Conclusion An ultrasound-guided ESPB used in Nuss surgery for children with funnel chest can provide good analgesia for surgery and shorten the postoperative rehabilitation and hospitalization time of patients. It is a safe and effective alternative to TEA.
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Fiorelli S, Menna C, Andreetti C, Peritore V, Rocco M, De Blasi RA, Rendina EA, Massullo D, Ibrahim M. Bilateral Ultrasound-Guided Erector Spinae Plane Block for Pectus Excavatum Surgery: A Retrospective Propensity-Score Study. J Cardiothorac Vasc Anesth 2022; 36:4327-4332. [PMID: 36163156 DOI: 10.1053/j.jvca.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/17/2022] [Accepted: 08/22/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Pectus excavatum (PE) repair is burdened by severe postoperative pain. This retrospective study aimed to determine whether the analgesic effect of ultrasound-guided erector spinae plane block (ESPB) plus standard intravenous analgesia (SIVA) might be superior to SIVA alone in pain control after PE surgical repair via Ravitch or Nuss technique. DESIGN A retrospective cohort study. SETTING At a university hospital. PARTICIPANTS All participants were scheduled for surgical repair of PE. INTERVENTIONS From January 2017 to December 2019, all patients who received ESPB plus SIVA or SIVA alone were investigated retrospectively. A 2:1 propensity-score matching analysis considering preoperative variables was used to compare analgesia efficacy in 2 groups. All patients received a 24-hour continuous infusion of tramadol, 0.1 mg/kg/h, and ketorolac, 0.05 mg/kg/h, via elastomeric pump, and morphine, 2 mg, intravenously as a rescue drug. The ESPB group received preoperative bilateral ESPB block. Postoperative pain, reported using a numerical rating scale at 1, 12, 24, and 48 hours after surgery; the number of required rescue doses; total postoperative morphine milligram equivalents consumption; and the incidence of postoperative nausea and vomit were analyzed. MEASUREMENT AND MAIN RESULTS A total of 105 patients were identified for analysis. Propensity-score matching resulted in 38 patients in the SIVA group and 19 patients in the ESPB group. Postoperative pain, the number of rescue doses, and postoperative nausea and vomit incidences were lower in the ESPB group (p < 0.005). CONCLUSIONS Erector spinae plane block may be an effective option for pain management after surgical repair of PE as part of a multimodal approach. This study showed good perioperative analgesia, opioid sparing, and reduced opioid-related adverse effects.
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Affiliation(s)
- Silvia Fiorelli
- Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
| | - Cecilia Menna
- Thoracic Surgery, Department of Clinical and Surgical Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Claudio Andreetti
- Thoracic Surgery, Department of Clinical and Surgical Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Valentina Peritore
- Thoracic Surgery, Department of Clinical and Surgical Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Monica Rocco
- Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Roberto Alberto De Blasi
- Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Erino Angelo Rendina
- Thoracic Surgery, Department of Clinical and Surgical Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Domenico Massullo
- Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Mohsen Ibrahim
- Thoracic Surgery, Department of Clinical and Surgical Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Chidambaran V, Garcia VF, Brown RL. Are We Ready for Cryoablation in Children Undergoing Nuss Procedures? Anesth Analg 2022; 134:881-884. [PMID: 35299214 DOI: 10.1213/ane.0000000000005857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - Victor F Garcia
- Department of Surgical Services, Division of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Rebeccah L Brown
- Department of Surgical Services, Division of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Largo-Pineda CE, González-Giraldo D, Zamudio-Burbano M. Erector Spinae Plane Block. A narrative review. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2022. [DOI: 10.5554/22562087.e1020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The erector spinae plane (ESP) block is an interfascial block described in 2016 by Forero and collaborators, with wide clinical uses and benefits when it comes to analgesic control in different surgeries. This block consists of the application of local anesthetic (LA) in a deep plane over the transverse process, anterior to the erector spinae muscle in the anatomical site where dorsal and ventral branches of the spinal nerve roots are located.
This review will cover its clinical uses according to different surgical models, the existing evidence and complications described to date.
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Singh S, Andaleeb R, Lalin D. Can ultrasound-guided erector spinae plane block replace thoracic epidural analgesia for postoperative analgesia in pediatric patients undergoing thoracotomy? A prospective randomized controlled trial. Ann Card Anaesth 2022; 25:429-434. [PMID: 36254906 PMCID: PMC9732960 DOI: 10.4103/aca.aca_269_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Many analgesic modalities have been investigated in pediatrics for thoracotomy. We studied the analgesic efficacy of unilateral continuous ultrasound-guided erector spinae plane block (ESPB) compared to a thoracic epidural in pediatric patients undergoing thoracotomy. MATERIALS AND METHODS A prospective, randomized, observer-blinded, controlled study. Pediatric patients (2-7 years) scheduled for right or left thoracotomy under general anesthesia (GA) were enrolled in the study. We randomly assigned patients into two groups: The thoracic epidural analgesia (TEA) group received GA with an epidural catheter. The ESPB group received GA with a unilateral ultrasound-guided erector spinae plane catheter. The primary outcome was postoperative cumulative opioid consumption for 24 h. RESULTS The total intraoperative fentanyl requirement was 35.4 ± 11.44 μg in the TEA group and 30.4 ± 9.08 μg in the ESPB group (t-value - 1.53013, P value: 0.134). The total postoperative fentanyl requirement was comparable in both the groups and clinically nonsignificant (44 ± 2.82 in the TEA group vs. 44.25 ± 13.72 in the ESPB group, t-value = -0.02412, P = 0.981). The median (IQR) Face, Legs, Activity, Cry, and Consolability (FLACC) score at 0, 2, 4, 8, 12, and 24 h time points in the ESPB was equivalent to the TEA group. At 6 h time point, the TEA group had a significantly lower FLACC score than the ESPB group (1[1.75, 1] in the TEA group and 2 [2, 1] in the ESPB group, P value = .02, U = 117.5, z-score = -2.218). The complications were higher in the TEA group (urine retention 20% and hypotension 40%) than in the ESPB group (0 and 0%). CONCLUSIONS This study shows that the ESPB provides similar postoperative analgesia to the TEA in pediatric patients undergoing thoracotomy. The ESPB is simpler, faster, and has a lower complication rate.
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Affiliation(s)
- Swati Singh
- Department of Anesthesiology and Intensive Care, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India,Address for correspondence: Dr. Swati Singh, Department of Anesthesiology and Intensive Care, First Floor, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, Bihar, India. E-mail:
| | - Roshan Andaleeb
- Department of Anesthesiology and Intensive Care, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Dusu Lalin
- Department of Anesthesiology and Intensive Care, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
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Aréchiga-Ornelas GE, Ramos-Guerrero JA, Bueno-Acosta PH, Del Río-Parra M, Sotelo-Rosero O, Coria-Márquez JA, Contreras-Martínez Ó, Apraez-Erazo JA. Erector Spinae Plane Block in pediatric cancer pain: Case report. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2021. [DOI: 10.5554/22562087.e1014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The advent of the erector spinae plane block brought about new therapeutic options as part of a multimodal analgesia strategy, as evidenced in this case, which describes a five-year old pre-school patient who presented with severe abdominal cancer pain, secondary to an abdominal neuroblastoma, with partial high-dose opioid response, undergoing bilateral erector spinal plane block. The technique used did not give rise to complications and proved to be effective in blocking pain and reducing the dose of opioids 36 hours after the procedure. The paper discusses the variables involved in the mode of administration (continuous infusion vs. bolus) and the benefit for optimal analgesia in the pediatric oncology setting.
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Ren Y, Zheng T, Hua L, Zhang F, Ma Y, Zhang J. The Effect of Ultrasound-Guided Erector Spinae Plane Block versus Thoracic Epidural Block on Postoperative Analgesia After Nuss Surgery in Paediatric Patients: Study Protocol of a Randomized Non-Inferiority Design Trial. J Pain Res 2021; 14:3047-3055. [PMID: 34611435 PMCID: PMC8487277 DOI: 10.2147/jpr.s332078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/23/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The Nuss procedure is a recognized treatment for adolescent pectus excavatum that results in severe postoperative pain. Erector spinae plane block (ESPB) is a novel technique that provides postoperative analgesia and reduces opioid consumption. Our aim is to explore whether ESPB produces analgesia similar to thoracic epidural anaesthesia (TEA) in paediatric patients undergoing Nuss procedure. Study Design and Methods This randomized, controlled, non-inferiority trial will enrol 300 paediatric patients undergoing Nuss surgery. Participants will be randomly assigned 1:1 to receive ESPB or TEA preoperatively. The primary, joint endpoint is the average numeric rating scale (NRS) score and cumulative sufentanil consumption. The secondary endpoints are pain scores and sufentanil consumption at different time points after surgery, analgesia-related side effects, and other postoperative complications. Data will be analysed by the intention-to-treat principle. Discussion This study investigates the effect of ESPB on postoperative opioid consumption and pain scores and intend to provide a new strategy of analgesia management for Nuss procedure in paediatric patients.
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Affiliation(s)
- Yi Ren
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Tiehua Zheng
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Lei Hua
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Fuzhou Zhang
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Yangwei Ma
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Jianmin Zhang
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
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Abstract
Over the past few decades, there have been many advances in pediatric surgery, some using new devices (eg, VEPTR, MAGEC rods) and others using less invasive approaches (eg, Nuss procedure, endoscopic cranial suture release, minimally invasive tethered cord release). Although many of these procedures were initially met with caution or skepticism, continued experience over the past few decades has shown that these procedures are safe and effective. This article reviews the anesthetic considerations for these conditions and procedures.
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Affiliation(s)
- Johanna Meehyun Lee
- Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, GRB 444, Boston, MA 02114, USA
| | - Erica Gee
- Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, GRB 444, Boston, MA 02114, USA
| | - Chang Amber Liu
- Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, GRB 444, Boston, MA 02114, USA.
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Holland EL, Bosenberg AT. Early experience with erector spinae plane blocks in children. Paediatr Anaesth 2020; 30:96-107. [PMID: 31883421 DOI: 10.1111/pan.13804] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/21/2019] [Accepted: 12/23/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND An erector spinae plane block is a relatively new regional anesthetic technique. Apart from case reports and small series, the literature regarding pediatric use is limited. AIM Our objective was to determine the efficacy of the erector spinae plane block in children by measuring the heart rate response to incision. Secondary objectives included feasibility, safety, opioid consumption, and pain scores. Furthermore, we reviewed this block in children published since 2016. STUDY DESIGN Case Series; Level of evidence, IV. METHODS With Institutional Review Board approval, a retrospective chart review was conducted on all patients who received erector spinae plane block for surgery between October 2017 and May 2019 at a single institution. Blocks were performed under anesthesia, using ultrasound guidance prior to surgical incision. Block details and hemodynamic and analgesic data were collected. In addition, a PubMed literature review was conducted to identify all erector spinae plane block related publications in patients ≤18 years of age. RESULTS About 164 patients, 2 days-19.4 years, weighing 2.3-94.7 kg, received erector spinae plane blocks. For more than 79% of single injection blocks, placement time was ≤10 minutes. Using a heart rate increase of <10% at skin incision as criterion, 70.1% of patients had a successful block. Only 20% required long-acting opioids intraoperatively. In a subset of infants who underwent gastrostomy surgery using a dose of 0.5 mL/kg, a local anesthetic spread of at least five dermatomes (0.1 mL/kg/dermatome) was achieved. Per the literature review, 33 publications described erector spinae plane block in 128 children. No complications were reported. CONCLUSION Erector spinae plane blocks are relatively easy to perform in children with no complications reported to date. The efficacy of the block for a broad spectrum of surgeries, involving incisions from T1 to L4, is encouraging.
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Affiliation(s)
- Erica L Holland
- Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - Adrian T Bosenberg
- Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, Seattle, WA, USA
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Yoshizaki M, Murata H, Ogami-Takamura K, Hara T. Bilateral erector spinae plane block using a programmed intermittent bolus technique for pain management after Nuss procedure. J Clin Anesth 2019; 57:51-52. [DOI: 10.1016/j.jclinane.2019.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 02/26/2019] [Accepted: 03/03/2019] [Indexed: 10/27/2022]
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Nasr VG, Gottlieb EA, Adler AC, Evans MA, Sawardekar A, DiNardo JA, Mossad EB, Mittnacht AJ. Selected 2018 Highlights in Congenital Cardiac Anesthesia. J Cardiothorac Vasc Anesth 2019; 33:2833-2842. [DOI: 10.1053/j.jvca.2019.03.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 03/05/2019] [Indexed: 01/19/2023]
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Tulgar S, Ahiskalioglu A, De Cassai A, Gurkan Y. Efficacy of bilateral erector spinae plane block in the management of pain: current insights. J Pain Res 2019; 12:2597-2613. [PMID: 31695476 PMCID: PMC6717717 DOI: 10.2147/jpr.s182128] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 08/06/2019] [Indexed: 12/21/2022] Open
Abstract
Erector spinae plane block (ESPB) is a newly described interfascial plane block, and the number of articles on the bilateral application of ESPB is increasing in the literature. In this paper, in addition to analyzing bilateral ESPB cases and studies published so far, we aimed to review the relevant anatomy, describe the mechanism of spread of the injectant, demonstrate varying approaches to ESPB, and summarize case reports and clinical trials, as well as provide current insight on this emerging and popular block. Randomized controlled studies, comparative studies of ESPB versus other methods, and pharmacokinetic studies of bilateral applications must be the next step in clearly understanding bilateral ESPB.
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Affiliation(s)
- Serkan Tulgar
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Maltepe University, Istanbul, Turkey
| | - Ali Ahiskalioglu
- Department of Anaesthesiology and Reanimation, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Alessandro De Cassai
- Section of Anaesthesiology and Intensive Care, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Yavuz Gurkan
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Koç University, Istanbul, Turkey
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Aksu C, Gurkan Y. Defining the Indications and Levels of Erector Spinae Plane Block in Pediatric Patients: A Retrospective Study of Our Current Experience. Cureus 2019; 11:e5348. [PMID: 31602352 PMCID: PMC6779152 DOI: 10.7759/cureus.5348] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim The primary aim of this study was to evaluate the indications, effectiveness, application levels, and local anesthetic (LA) dosages used in erector spinae plane block (ESPB) in pediatric patients
based on our clinical data. The secondary aim was to compare previously reported pediatric ESPBs with our data and to prepare a mini-guide for future clinical applications. Materials and methods One hundred and forty-one pediatric patients who received ESPB and were operated by the Department of Pediatric Surgery were included in this retrospective observational study. ESPB is routinely performed with 0.5 ml/kg 0.25% bupivacaine (max 20 ml). Demographic data and the type of surgery were recorded. Face, Legs, Activity, Cry, and Consolability (FLACC) or Numeric Rating Scale (NRS) scores, analgesic requirements, and the type of analgesic administered at postoperative period were recorded. Results ESPB was applied using three different techniques, the classic approach, the transverse approach, and the Aksu approach. Unilateral ESPB was performed on 112 patients, while 29 received a bilateral block. ESPB used for 13 different indications. Conclusion ESPB is a relatively safe and effective procedure for achieving opioid-free postoperative analgesia in many different surgical procedures in pediatric patients.
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Affiliation(s)
- Can Aksu
- Anesthesiology, Kocaeli University, Kocaeli, TUR
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Use of the bilateral erector spinae (ESP) block for postoperative analgesia following the removal of the Nuss bar. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2019. [DOI: 10.1097/cj9.0000000000000109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kot P, Rodriguez P, Granell M, Cano B, Rovira L, Morales J, Broseta A, Andrés JD. The erector spinae plane block: a narrative review. Korean J Anesthesiol 2019; 72:209-220. [PMID: 30886130 PMCID: PMC6547235 DOI: 10.4097/kja.d.19.00012] [Citation(s) in RCA: 132] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/13/2019] [Indexed: 11/17/2022] Open
Abstract
Regional anesthesia and pain management have experienced advances in recent years, especially with the advent of fascial plane blocks. The erector spinae plane block is one of the newest techniques to be described. In the past two years, publications referring to ESP block have increased significantly. The objective of this review is to analyze the articles about ESP block that have been published to date. We performed a search in the main databases and identified 368 articles. After a selection of the relevant articles, 125 studies were found eligible and were included in the review. The ESP block is performed by depositing the local anesthetic in the fascial plane, deeper than the erector spinae muscle at the tip of the transverse process of the vertebra. Many cases of its use have been described with satisfactory results in the treatment of both acute pain and chronic pain. The applicability of the technique covers many clinical scenarios. Of the 98 case reports reviewed, 12 and 87 articles, respectively described the technique as a treatment for chronic pain and acute pain. The single-shot was the most frequently used technique. As described in the articles published to date, the technique is easy to perform and has a low rate of complications. However, despite the effectiveness of the technique, further studies are necessary to obtain more evidence of its actions.
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Affiliation(s)
- Pablo Kot
- Department of Anesthesia, Critical Care and Pain Medicine, University General Hospital Consortium of Valencia, Spain
| | - Pablo Rodriguez
- Department of Anesthesia, Critical Care and Pain Medicine, University General Hospital Consortium of Valencia, Spain
| | - Manuel Granell
- Department of Anesthesia, Critical Care and Pain Medicine, University General Hospital Consortium of Valencia, Spain
| | - Beatriz Cano
- Department of Hospital Nursing, University General Hospital Consortium of Valencia, Valencia, Spain
| | - Lucas Rovira
- Department of Anesthesia, Critical Care and Pain Medicine, University General Hospital Consortium of Valencia, Spain
| | - Javier Morales
- Department of Anesthesia, Critical Care and Pain Medicine, University General Hospital Consortium of Valencia, Spain
| | - Ana Broseta
- Department of Anesthesia, Critical Care and Pain Medicine, University General Hospital Consortium of Valencia, Spain
| | - Jose De Andrés
- Department of Anesthesia, Critical Care and Pain Medicine, University General Hospital Consortium of Valencia, Spain
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De Cassai A, Bonvicini D, Correale C, Sandei L, Tulgar S, Tonetti T. Erector spinae plane block: a systematic qualitative review. Minerva Anestesiol 2019; 85:308-319. [DOI: 10.23736/s0375-9393.18.13341-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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