Effectiveness of erector spinae plane block in reducing opioid consumption after colorectal surgery: A comprehensive meta-analysis

Despite the life-saving nature of colorectal surgeries, patients often experience intra and post-operative problems, especially pain and discomfort. This meta-analysis aimed to evaluate the effectiveness of erector spinae plane block (ESP block) in postoperative pain management for patients undergoing colorectal surgeries. A comprehensive systematic literature search was conducted in PubMed and Cochrane Library databases from inception until December 2023. Eight studies were deemed appropriate for inclusion. The pooled analysis demonstrated a significant decrease with the ESP block compared to the control group in postoperative opioid consumption [MD ​= ​-15.96 ​mg; 95 ​% CI (-28.74 to -3.18); p ​= ​0.014, I2 ​= ​87 ​%], intraoperative opioid consumption [MD ​= ​-35.51 ​mg; 95 ​% CI (-62.63 to -8.40); p ​= ​0.010, I2 ​= ​87 ​%], pain scores [MD ​= ​-0.94; 95 ​% CI (-1.27 to -0.60); p ​< ​0.000001, I2 ​= ​86 ​%], with a significantly shorter duration of hospital stay [MD ​= ​-1.25 days; 95 ​% CI (-2.02 to -0.48); p ​= ​0.002, I2 ​= ​23 ​%]. This meta-analysis support the use of erector spinae plane block (ESP) for postoperative pain management in colorectal surgeries. ESP shows significant reductions in opioid consumption, pain scores and hospital stay.

Comparison of totally automated and manual processing for calculation of left ventricular volumes and ejection fraction using gated myocardial perfusion SPECT

ated single-photon emission computed tomography (SPECT) allows for the assessment of myocardial left ventricular ejection fraction and left ventricular volumes. There is conflicting data regarding the difference between automated and manual processing of gated myocardial SPECT images. The purpose of this retrospective “cross-sectional study is to compare the degree of variability between automated and manual processing of Quantitative Gated SPECT algorithms for assessing left ventricular volumes and ejection percent”. Study was carried out in the Nuclear Medicine department “at the Security Forces Hospital, Riyadh, Saudi Arabia, and comprised of 96 participants who “underwent” both stress and “rest gated” myocardial perfusion “imaging” (MPI) from February to May 2021. Data were analyzed “using SPSS for Windows (version 22; IBM Corp., Armonk, NY, USA). The mean of EF, ESV, and EDV on stress test using the automatic technique were 62.46 ± 14.62%, 45.00 ± 37.10 ml, and 107.01 ± 43.70 ml, respectively while using the manual technique were 57.21±14.80%, 44.35±35.93 ml, and 93.26±39.14 ml, respectively. The mean of EF, ESV, and EDV on rest test using the automatic technique were 62.85± 15.47%, 43.44± 36.35 ml, and 104.27±42.51 ml, respectively while using the manual technique were 57.74±15.33%, 43.30±36.42 ml, and 91.72±41.50 ml, respectively. For LVEF and EDV, the difference between automated and manual techniques is statistically significant (p<0.05). However, no “statistically significant difference” exists between automated and manual ESV techniques (p>0.05). Discrepancies were observed that exist by using the fully automated and manual technique for determining LVEF and Left ventricular volumes by gated MPI.