Effect of Ultrasound-Guided Erector Spinae Plane Block on Postoperative Pain and Intraoperative Opioid Consumption in Bariatric Surgery.
Bariatric surgery
Erector spinae plane block (ESPB)
Morbid obesity
Opioids
Ultrasound guidance
Visual analogue scale (VAS) score
Journal
Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
25
04
2021
accepted:
20
08
2021
revised:
20
08
2021
pubmed:
28
8
2021
medline:
11
3
2022
entrez:
27
8
2021
Statut:
ppublish
Résumé
Bariatric surgery is often associated with moderate to severe pain. In patients with obesity, opioids have the potential to induce ventilatory impairment; thus, opioid use needs to be limited. This study aimed to compare the novel ultrasound-guided erector spinae plane block (ESPB) technique with controls in terms of intraoperative opioid consumption and postoperative pain control. A total of 63 patients with morbid obesity who underwent laparoscopic bariatric surgery were included in this randomized study. Patients were randomly assigned to the bilateral erector spinae plane block (ESPB) group or the control group. To evaluate perioperative pain and to adjust opioid dose, analgesia nociception index (ANI) was monitored during surgery. Total opioid dose was recorded for each patient. In addition, pain was evaluated using visual analogue scale (VAS) scores for 24 h following the operation. Total intraoperative remifentanil dose was significantly lower in the ESPB group when compared to controls (1356.3 ± 177.8 vs. 3273.3 ± 961.9 mcg, p < 0.001). In the ESPB group, none of the patients required additional analgesia during follow-up. In contrast, all control patients required analgesia. ESPB group had significantly lower VAS scores at all postoperative time points (p < 0.001 for all). Bilateral ultrasound-guided ESPB appears to be a simple and effective technique to improve perioperative pain control and reduce intraoperative opioid need in patients with morbid obesity undergoing bariatric surgery.
Sections du résumé
BACKGROUND
Bariatric surgery is often associated with moderate to severe pain. In patients with obesity, opioids have the potential to induce ventilatory impairment; thus, opioid use needs to be limited. This study aimed to compare the novel ultrasound-guided erector spinae plane block (ESPB) technique with controls in terms of intraoperative opioid consumption and postoperative pain control.
METHODS
A total of 63 patients with morbid obesity who underwent laparoscopic bariatric surgery were included in this randomized study. Patients were randomly assigned to the bilateral erector spinae plane block (ESPB) group or the control group. To evaluate perioperative pain and to adjust opioid dose, analgesia nociception index (ANI) was monitored during surgery. Total opioid dose was recorded for each patient. In addition, pain was evaluated using visual analogue scale (VAS) scores for 24 h following the operation.
RESULTS
Total intraoperative remifentanil dose was significantly lower in the ESPB group when compared to controls (1356.3 ± 177.8 vs. 3273.3 ± 961.9 mcg, p < 0.001). In the ESPB group, none of the patients required additional analgesia during follow-up. In contrast, all control patients required analgesia. ESPB group had significantly lower VAS scores at all postoperative time points (p < 0.001 for all).
CONCLUSION
Bilateral ultrasound-guided ESPB appears to be a simple and effective technique to improve perioperative pain control and reduce intraoperative opioid need in patients with morbid obesity undergoing bariatric surgery.
Identifiants
pubmed: 34449029
doi: 10.1007/s11695-021-05681-7
pii: 10.1007/s11695-021-05681-7
doi:
Substances chimiques
Analgesics, Opioid
0
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
5176-5182Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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