Effect of low thoracic erector spinae block on postoperative pain management in patients undergoing lumbar microdiscectomy surgery

Ebru Biricik; Feride Karacaer; Demet Laflı Tunay; Murat Türkeün Ilgınel; Kadir Oktay; Hakkı Ünlügenç; Yasemin Güneş

Makale detayları

Effect of low thoracic erector spinae block on postoperative pain management in patients undergoing lumbar microdiscectomy surgery

Yazarlar:

Ebru Biricik | Feride Karacaer | Demet Laflı Tunay | Murat Türkeün Ilgınel | Kadir Oktay | Hakkı Ünlügenç | Yasemin Güneş

Yayıncı:

Cukurova University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Cukurova Medical Journal Vol.48 Issue 2, pp.489-498

Belge Tipi:

Makale

Yayın Tarihi:

2/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001286343

pISSN:

2602-3032

Anahtar kelimeler:

Özet:

 Purpose: Lumbar disk hernia is very common reason for spinal surgery and usually treats with surgical interventions. The primary aim of this randomized controlled study was to determine the effect of low thoracic ultrasound guided erector spinae plane ESP block on postoperative pain management in lumbar microdiscectomy surgery. Materials and Methods: Totally 42 adults scheduled for elective lumbar microdiscectomy surgery and assigned into two groups as Group ESP and Group Control. Anesthesia was induced with propofol 2mgkg, rocuronium 0.6 mgkg, fentanil 2µgkg and maintained with total intravenous anesthesia propofol 4-8 mgkgh and remifentanil 0.03-0.05 µgkgmin, N2OO2 mixture 6040 for all patients. When patients were positioned at prone, ESP or sham block performed bilaterally. ESP performed with bupivacain 0.5 15 mLlidocain 2 5 mL in ESP group and saline 20 mL for sham group at the T10 level of spine. The postoperative analgesia provided with morphine 0.1 mgkg intravenously and diclofenac Na 75 mg intramuscularly at last 30 minutes of surgery for all patients. Postoperative visual analog scale VAS scores, meperidine requirements and patients satisfaction were recorded. Results: There were significant differences between Group ESP and Group Control in meperidine requirement, VAS scores at rest and leg movement and patients satisfaction. Time to first analgesic need was median 62.5 min interquartile range 5-180 in Group ESP and median 7.50 min interquartile range 5-10 in Group Control. Conclusion: ESP can significantly reduce postoperative pain scores VAS at rest and leg movement, meperidine requirement and can provide better patients satisfaction, postoperatively.

 Purpose: Lumbar disk hernia is very common reason for spinal surgery and usually treats with surgical interventions. The primary aim of this randomized controlled study was to determine the effect of low thoracic ultrasound guided erector spinae plane ESP block on postoperative pain management in lumbar microdiscectomy surgery. Materials and Methods: Totally 42 adults scheduled for elective lumbar microdiscectomy surgery and assigned into two groups as Group ESP and Group Control. Anesthesia was induced with propofol 2mgkg, rocuronium 0.6 mgkg, fentanil 2µgkg and maintained with total intravenous anesthesia propofol 4-8 mgkgh and remifentanil 0.03-0.05 µgkgmin, N2OO2 mixture 6040 for all patients. When patients were positioned at prone, ESP or sham block performed bilaterally. ESP performed with bupivacain 0.5 15 mLlidocain 2 5 mL in ESP group and saline 20 mL for sham group at the T10 level of spine. The postoperative analgesia provided with morphine 0.1 mgkg intravenously and diclofenac Na 75 mg intramuscularly at last 30 minutes of surgery for all patients. Postoperative visual analog scale VAS scores, meperidine requirements and patients satisfaction were recorded. Results: There were significant differences between Group ESP and Group Control in meperidine requirement, VAS scores at rest and leg movement and patients satisfaction. Time to first analgesic need was median 62.5 min interquartile range 5-180 in Group ESP and median 7.50 min interquartile range 5-10 in Group Control. Conclusion: ESP can significantly reduce postoperative pain scores VAS at rest and leg movement, meperidine requirement and can provide better patients satisfaction, postoperatively.

 Purpose: Lumbar disk hernia is very common reason for spinal surgery and usually treats with surgical interventions. The primary aim of this randomized controlled study was to determine the effect of low thoracic ultrasound guided erector spinae plane ESP block on postoperative pain management in lumbar microdiscectomy surgery. Materials and Methods: Totally 42 adults scheduled for elective lumbar microdiscectomy surgery and assigned into two groups as Group ESP and Group Control. Anesthesia was induced with propofol 2mgkg, rocuronium 0.6 mgkg, fentanil 2µgkg and maintained with total intravenous anesthesia propofol 4-8 mgkgh and remifentanil 0.03-0.05 µgkgmin, N2OO2 mixture 6040 for all patients. When patients were positioned at prone, ESP or sham block performed bilaterally. ESP performed with bupivacain 0.5 15 mLlidocain 2 5 mL in ESP group and saline 20 mL for sham group at the T10 level of spine. The postoperative analgesia provided with morphine 0.1 mgkg intravenously and diclofenac Na 75 mg intramuscularly at last 30 minutes of surgery for all patients. Postoperative visual analog scale VAS scores, meperidine requirements and patients satisfaction were recorded. Results: There were significant differences between Group ESP and Group Control in meperidine requirement, VAS scores at rest and leg movement and patients satisfaction. Time to first analgesic need was median 62.5 min interquartile range 5-180 in Group ESP and median 7.50 min interquartile range 5-10 in Group Control. Conclusion: ESP can significantly reduce postoperative pain scores VAS at rest and leg movement, meperidine requirement and can provide better patients satisfaction, postoperatively.

 Amaç: Lomber disk hernisi spinal cerrahi için çok yaygın bir nedendir ve genellikle cerrahi müdahalelerle tedavi edilir. Bu randomize kontrollü çalışmanın birincil amacı, lomber mikrodiskektomi cerrahisinde ultrason kılavuzluğunda alt torasik erektör spina plan ESP bloğunun postoperatif ağrı yönetimine etkisini belirlemektir. Gereç ve Yöntem: Elektif lomber mikrodiskektomi ameliyatı planlanan toplam 42 erişkin, Grup ESP ve Grup Kontrol olmak üzere iki gruba ayrıldı. Anestezi indüksiyonu propofol 2mgkg, roküronyum 0,6 mgkg, fentanil 2µgkg ile sağlandı ve total intravenöz anestezi propofol 4-8 mgkgsa ve remifentanil 0,03-0,05 µgkgdk, N2OO2 6040 karışım ile tüm hastalara anestezi idamesi sağlandı. Hastalar yüzüstü pozisyondayken bilateral olarak ESP veya sham blok uygulandı. ESP grubuna 15 mL bupivacain 0,5 5 mL lidocain 2, sham grubuna ise salin 20 mL ile omurganın T10 seviyesinden ESP uygulandı. Tüm hastalara ameliyatın son 30 dakikasında morfin 0,1 mgkg intravenöz ve diklofenak Na 75 mg intramüsküler olarak postoperatif analjezi sağlandı. Postoperatif vizüel analog skala VAS skorları, meperidin gereksinimleri ve hasta memnuniyeti kaydedildi. Bulgular: Grup ESP ve Grup Kontrol arasında meperidin gereksinimi, istirahat ve bacak hareketi sırasındaki VAS skorları ve hasta memnuniyeti açısından anlamlı fark vardı. İlk analjezik ihtiyacına kadar geçen süre, Grup ESP de ortanca 62,5 dakika çeyrekler arası aralık 5-180 ve Grup Kontrol de ortanca 7,50 dakika çeyrekler arası aralık 5-10 idi. Sonuç: ESP, postoperatif ağrı skorlarını istirahat ve bacak hareketinde VAS, meperidin gereksinimini önemli ölçüde azaltabilir ve postoperatif hasta memnuniyetini daha iyi sağlayabilir.

Makale detayları

Effect of low thoracic erector spinae block on postoperative pain management in patients undergoing lumbar microdiscectomy surgery

Yazarlar:

Ebru Biricik | Feride Karacaer | Demet Laflı Tunay | Murat Türkeün Ilgınel | Kadir Oktay | Hakkı Ünlügenç | Yasemin Güneş

Yayıncı:

Cukurova University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Cukurova Medical Journal Vol.48 Issue 2, pp.489-498

Belge Tipi:

Makale

Yayın Tarihi:

2/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001286343

pISSN:

2602-3032

Low thoracic ESP

Postoperative Analgesia

Lumbar Surgery

Microdiscectomy

Erektör spina plan bloğu

spinal cerrahi

postoperatif analjezi

alt torasik erektör spina bloğu

bölgesel analjezi

ağrı yönetimi.

Sayı

Makale detayları

Yazarlar: Ebru Biricik | Feride Karacaer | Demet Laflı Tunay | Murat Türkeün Ilgınel | Kadir Oktay | Hakkı Ünlügenç | Yasemin Güneş

Yayıncı: Cukurova University

Ana Başlıklar: Klinik Tıp Bilimleri

Dergi: Cukurova Medical Journal Vol.48 Issue 2, pp.489-498

Belge Tipi: Makale

Yayın Tarihi: 2/2023

Belge Dili: İngilizce

Document ID (Org No.): 2001286343

pISSN: 2602-3032

Sayı

Yazarlar:

Ebru Biricik | Feride Karacaer | Demet Laflı Tunay | Murat Türkeün Ilgınel | Kadir Oktay | Hakkı Ünlügenç | Yasemin Güneş

Yayıncı:

Cukurova University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Cukurova Medical Journal Vol.48 Issue 2, pp.489-498

Belge Tipi:

Makale

Yayın Tarihi:

2/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001286343

pISSN:

2602-3032