Effects of ultrasound-guided erector spinae plane block in radical prostatectomy surgery on pain and surgical stress response
Tóm tắt
Erector spina plane block, as a part of a multimodal approach in perioperative pain management, is effective in many surgical procedures on pain management. The aim of this prospective, randomized, controlled study was to investigate the effects of erector spinae plane block on pain, analgesic consumption, and surgical stress in radical prostatectomy operations. Forty-six patients operated for elective open radical prostatectomy surgery were randomly allocated to Group B (n = 23) and Group K (n = 23). Ultrasound-guided erector spinae plane block was performed bilaterally on patients in Group B, while group K was the control group. Remifentanil and tramadol consumption, rescue analgesic need, pain scores, and nausea-vomiting scores were less in Group B. While there was no difference in glucose, cortisol, insulin, and C-reactive protein values at all times between groups, postoperative 24-h prolactin values were higher in Group B. Shapiro–Wilk test, Student t-test, and Mann–Whitney U-test were used for statistical analysis. Ultrasound-guided erector spinae plane block is an effective analgesic method in radical retropubic prostatectomy surgeries providing a reduction in intraoperative and postoperative opioid consumption but has limited effect on the surgical stress response. ClinicalTrials NCT05170373, Registered 11/03/2021 — retrospectively registered. Acute pain develops as a result of tissue damage caused by surgical trauma in radical prostatectomy. Erector spina plane block applying local anesthetic between the erector spina muscle and the vertebral transverse has provided effective perioperative pain management.
Tài liệu tham khảo
Bagry H, de la Cuadra Fontaine JC, Asenjo JF, Bracco D, Carli F (2008) Effect of a continuous peripheral nerve block on the inflammatory response in knee arthroplasty. Reg Anesth Pain Med Jan-Feb 33(1):17–23. https://doi.org/10.1016/j.rapm.2007.06.398
BeverlyKayeLjungqvistUrman AADORD (2017) Essential elements of multimodal analgesia in enhanced recovery after surgery (ERAS) guidelines. Anesthesiol Clin 35(2):e115–e143. https://doi.org/10.1016/j.anclin.2017.01.018
Brodner G, Aken HV, Hertle L, Fobker M, Von Eckardstein A, Goeters C, Buerkle H, Harks A, Kehlet H (2001) Multimodal perioperative management–combining thoracic epidural analgesia, forced mobilization and oral nutrition–reduces hormonal and metabolic stress and improves convalescence after major urologic surgery. Anesth Analg 92(6):1594–1600. https://doi.org/10.1097/00000539-200106000-00049
CapdevilaRaminCapdevila MSX (2017) Regional anesthesia and analgesia after surgery in ICU. Curr Opin Crit Care 23(5):430–439. https://doi.org/10.1097/MCC.0000000000000440
ChellyPloskanychDaiNelson JETFJB (2011) Multimodal analgesic approach incorporating paravertebral blocks for open radical retropubic prostatectomy: a randomized double-blind placebo-controlled study. Can J Anaesth 58(4):371–378. https://doi.org/10.1007/s12630-010-9442-x
ChitnisTangMariano SSRER (2020) The role of regional analgesia in personalized postoperative pain management. Korean J Anesthesiol 73(5):363–371. https://doi.org/10.4097/kja.20323
Choi YJ, Kwon HJ, O J, Cho TH, Won JY, Yang HM, Kim SH. Influence of injectate volume on paravertebral spread in erector spinae plane block: an endoscopic and anatomical evaluation. PLoS One. 2019;14(10):e0224487. https://doi.org/10.1371/journal.pone.0224487
Coluzzi F, Savoia G, Paoletti F, Costantini A, Mattia C (2009) Postoperative pain survey in Italy (POPSI): a snapshot of current national practices. Minerva Anestesiol 75(11):622–631
Desborough JP (2000) The stress response to trauma and surgery. Br J Anaesth 85(1):109–117. https://doi.org/10.1093/bja/85.1.109
**Dost B, Kaya C, Ozdemir E, Ustun YB, Koksal E, Bilgin S, Bostancı Y. Ultrasound-guided erector spinae plane block for postoperative analgesia in patients undergoing open radical prostatectomy: a randomized, placebo-controlled trial. J Clin Anesth. 2021 Sep;72:110277. https://doi.org/10.1016/j.jclinane.2021.110277
Elsharkawy H, Bajracharya GR, El-Boghdadly K, Drake RL, Mariano ER. Comparing two posterior quadratus lumborum block approaches with low thoracic erector spinae plane block: an anatomic study. Reg Anesth Pain Med. 2019 Mar 28;rapm-2018–100147. https://doi.org/10.1136/rapm-2018-100147
Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ (2016) The erector spinae plane block a novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med 41(5):621–627. https://doi.org/10.1097/AAP.0000000000000451
HamedGodaBasionyFargalyAbdelhady MAASMMOSMA (2019) Erector spinae plane block for postoperative analgesia in patients undergoing total abdominal hysterectomy: a randomized controlled study original study. J Pain Res 30(12):1393–1398. https://doi.org/10.2147/JPR.S196501
KendallAlvesTraillOliveira MCLLLGS (2020) The effect of ultrasound-guided erector spinae plane block on postsurgical pain: a meta-analysis of randomized controlled trials. BMC Anesthesiol 20(1):99. https://doi.org/10.1186/s12871-020-01016-8
Kwon HM, Kim DH, Jeong SM, Choi KT, Park S, Kwon HJ, Lee JH (2020) Does erector spinae plane block have a visceral analgesic effect?: A randomized controlled trial. Sci Rep 10(1):8389. https://doi.org/10.1038/s41598-020-65172-0
Lepor H. Radical retropubic prostatectomy. Urol Clin North Am. 2001 Aug;28(3):509–19, viii. https://doi.org/10.1016/s0094-0143(05)70159-2
MooreDesboroughPowellBurrinHall CMJPHJMGM (1994) Effects of extradural anaesthesia on interleukin-6 and acute phase response to surgery. Br J Anaesth 72(3):272–279. https://doi.org/10.1093/bja/72.3.272
NaitoTamaiShinguShindoMatsuiSegawaNakaiMori YSKKTHYK (1992) Responses of plasma adrenocorticotropic hormone, cortisol and cytokines during and after upper abdominal surgery. Anesthesiology 77(3):426–431. https://doi.org/10.1097/00000542-199209000-00004
*Saadawi M, Layera S, Aliste J, Bravo D, Leurcharusmee P, Tran DQ. Erector spinae plane block: a narrative review with systematic analysis of the evidence pertaining to clinical indications and alternative truncal blocks. J Clin Anesth . 2021 Feb;68:110063. https://doi.org/10.1016/j.jclinane.2020.110063
Tulgar S, Ahiskalioglu A, De Cassai A, Gurkan Y (2019a) Efficacy of bilateral erector spinae plane block in the management of pain: current insights. J Pain Res 12:2597–2613. https://doi.org/10.2147/JPR.S182128
Tulgar S, Kose HC, Selvi O, Senturk O, Thomas DT, Ermis MN, Ozer Z (2018) Comparison of ultrasound-guided lumbar erector spinae plane block and transmuscular quadratus lumborum block for postoperative analgesia in hip and proximal femur surgery: a prospective randomized feasibility study. Anesth Essays Res Oct-Dec 12(4):825–831. https://doi.org/10.4103/aer.AER_142_18
Tulgar S, Selvi O, Senturk O, Serifsoy TE, Thomas DT. Ultrasound-guided erector spinae plane block: indications, complications, and effects on acute and chronic pain based on a single-center experience. Cureus . 2019b Jan 2;11(1):e3815. https://doi.org/10.7759/cureus.3815
Ueshima H, Hiroshi O (2018) Spread of local anesthetic solution in the erector spinae plane block. J Clin Anesth 45:23. https://doi.org/10.1016/j.jclinane.2017.12.007