Bilateral Erector Spinae Plane Block on Opioid-sparing Effect in Upper Abdominal Surgery: Study Protocol for a Bi-center Prospective Randomized Controlled Trial

Overview

Journal Trials

Publisher Biomed Central

Specialties General Medicine
Pharmacology

Date 2024 Nov 14

PMID 39538323

Authors

Changzhen Geng

Li Wang

Yaping Shi

Xinnan Shi

Hanyi Zhao

Ya Huang

Qiufang Ji

Yuanqiang Dai

Tao Xu

Affiliations

Soon will be listed here.

Abstract

Background: Erector spinae plane block (ESPB) is a promising technique for effective analgesia. It is still uncertain if ESPB offers the same opioid-sparing effect as thoracic paravertebral block (PVB) in midline incision for upper abdominal surgery.

Methods: The study is a prospective, bi-center, randomized, controlled, non-inferior trial. One hundred fifty-eight patients scheduled for upper abdominal surgery will be randomly assigned to receive bilateral ESPB or PVB before surgery. The primary outcome will be the equivalent cumulative analgesia dosage of sufentanil during the surgery, which is defined as the total dosage of sufentanil from anesthesia induction to tracheal extubation. The main secondary outcomes include postoperative complications and the quality of recovery-15 score at 24 h, 48 h, and 30 days after surgery.

Discussion: This study will assess the opioid-sparing efficacy of ESPB and PVB, complications, and the quality of recovery of two blocks.

Trial Registration: ChiCTR2300073030 ( https://www.chictr.org.cn/ ). Registered on 30 June 2023.

References

Baig M, Zmora O, Derdemezi J, Weiss E, Nogueras J, Wexner S . Use of the ON-Q pain management system is associated with decreased postoperative analgesic requirement: double blind randomized placebo pilot study. J Am Coll Surg. 2006; 202(2):297-305. DOI: 10.1016/j.jamcollsurg.2005.10.022. View

Portela D, Castro D, Romano M, Gallastegui A, Garcia-Pereira F, Otero P . Ultrasound-guided erector spinae plane block in canine cadavers: relevant anatomy and injectate distribution. Vet Anaesth Analg. 2020; 47(2):229-237. DOI: 10.1016/j.vaa.2019.10.005. View

Chin K, El-Boghdadly K . Mechanisms of action of the erector spinae plane (ESP) block: a narrative review. Can J Anaesth. 2021; 68(3):387-408. DOI: 10.1007/s12630-020-01875-2. View

Han Y, Dai Y, Shi Y, Zhang X, Xia B, Ji Q . Ultrasound-guided paravertebral blockade reduced perioperative opioids requirement in pancreatic resection: A randomized controlled trial. Front Surg. 2022; 9:903441. PMC: 9468231. DOI: 10.3389/fsurg.2022.903441. View

Sanderson B, Doane M . Transversus Abdominis Plane Catheters for Analgesia Following Abdominal Surgery in Adults. Reg Anesth Pain Med. 2017; 43(1):5-13. DOI: 10.1097/AAP.0000000000000681. View

Villa G, Lanini I, Amass T, Bocciero V, Calabrisotto C, Chelazzi C . Effects of psychological interventions on anxiety and pain in patients undergoing major elective abdominal surgery: a systematic review. Perioper Med (Lond). 2020; 9(1):38. PMC: 7722323. DOI: 10.1186/s13741-020-00169-x. View

Richardson J, Lonnqvist P, Naja Z . Bilateral thoracic paravertebral block: potential and practice. Br J Anaesth. 2011; 106(2):164-71. DOI: 10.1093/bja/aeq378. View

Forero M, Adhikary S, Lopez H, Tsui C, Chin K . The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuropathic Pain. Reg Anesth Pain Med. 2016; 41(5):621-7. DOI: 10.1097/AAP.0000000000000451. View

Hughes M, Ventham N, Mcnally S, Harrison E, Wigmore S . Analgesia after open abdominal surgery in the setting of enhanced recovery surgery: a systematic review and meta-analysis. JAMA Surg. 2014; 149(12):1224-30. DOI: 10.1001/jamasurg.2014.210. View

10.

Altiparmak B, Korkmaz Toker M, Uysal A, Kuscu Y, Gumus Demirbilek S . Ultrasound-guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy: Randomized, controlled trial. J Clin Anesth. 2019; 57:31-36. DOI: 10.1016/j.jclinane.2019.03.012. View

11.

Dagyaran I, Olesen C, Brix L . Patient-Experienced Quality During Postoperative Pain Management - A Phenomenological-Hermeneutic Study. J Perianesth Nurs. 2021; 37(2):253-259. DOI: 10.1016/j.jopan.2021.09.007. View

12.

Latenstein C, Hannink G, van der Bilt J, Donkervoort S, Eijsbouts Q, Heisterkamp J . A Clinical Decision Tool for Selection of Patients With Symptomatic Cholelithiasis for Cholecystectomy Based on Reduction of Pain and a Pain-Free State Following Surgery. JAMA Surg. 2021; 156(10):e213706. PMC: 8358816. DOI: 10.1001/jamasurg.2021.3706. View

13.

Koushik S, Bui A, Slinchenkova K, Badwal A, Lee C, Noss B . Analgesic Techniques for Rib Fractures-A Comprehensive Review Article. Curr Pain Headache Rep. 2023; 27(11):747-755. DOI: 10.1007/s11916-023-01172-9. View

14.

Viderman D, Aubakirova M, Abdildin Y . Erector Spinae Plane Block in Abdominal Surgery: A Meta-Analysis. Front Med (Lausanne). 2022; 9:812531. PMC: 8904394. DOI: 10.3389/fmed.2022.812531. View

15.

Tulgar S, Kapakli M, Senturk O, Selvi O, Serifsoy T, Ozer Z . Evaluation of ultrasound-guided erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy: A prospective, randomized, controlled clinical trial. J Clin Anesth. 2018; 49:101-106. DOI: 10.1016/j.jclinane.2018.06.019. View

16.

Alimian M, Imani F, Rahimzadeh P, Faiz S, Bahari-Sejahrood L, C Hertling A . Adding Dexmedetomidine to Bupivacaine in Ultrasound-guided Thoracic Paravertebral Block for Pain Management after Upper Abdominal Surgery: A Double-blind Randomized Controlled Trial. Anesth Pain Med. 2022; 11(6):e120787. PMC: 8908442. DOI: 10.5812/aapm.120787. View

17.

Park Y, Chu S, Yu E, Joo J . Comparison of the efficacy of erector spinae plane block according to the difference in bupivacaine concentrations for analgesia after laparoscopic cholecystectomy: a retrospective study. J Yeungnam Med Sci. 2022; 40(2):172-178. PMC: 10076922. DOI: 10.12701/jyms.2022.00500. View

18.

Zhu Q, Li L, Yang Z, Shen J, Zhu R, Wen Y . Ultrasound guided continuous Quadratus Lumborum block hastened recovery in patients undergoing open liver resection: a randomized controlled, open-label trial. BMC Anesthesiol. 2019; 19(1):23. PMC: 6380018. DOI: 10.1186/s12871-019-0692-z. View

19.

Fawcett W, Baldini G . Optimal analgesia during major open and laparoscopic abdominal surgery. Anesthesiol Clin. 2015; 33(1):65-78. DOI: 10.1016/j.anclin.2014.11.005. View

20.

Cui Y, Wang Y, Yang J, Ran L, Zhang Q, Huang Q . The Effect of Single-Shot Erector Spinae Plane Block (ESPB) on Opioid Consumption for Various Surgeries: A Meta-Analysis of Randomized Controlled Trials. J Pain Res. 2022; 15:683-699. PMC: 8910495. DOI: 10.2147/JPR.S346809. View