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Pre-operative erector spinae plane block should be considered a viable option for laparoscopic colectomies.
Wan, Fang-Ting; Chin, Shuen-Ern; Gwee, Ryan; Chong, Yvette; Au-Yong, Angie; Matthews, Abey; Zaw, Ma-Wai-Wai; Lie, Sui-An; Loh, Leonard; Koh, Daphne; Ladlad, Jasmine; Khoo, Nathanelle; Aw, Darius; Chong, Cheryl X Z; Ho, Leonard M L; Ng, Jia-Lin; Sivarajah, Sharmini S; Tan, Winson J; Foo, Fung-Joon; Koh, Frederick H.
Afiliação
  • Wan FT; Lee Kong Chian School of Medicine, 11 Mandalay Road, Singapore, 308232, Singapore.
  • Chin SE; Lee Kong Chian School of Medicine, 11 Mandalay Road, Singapore, 308232, Singapore.
  • Gwee R; Lee Kong Chian School of Medicine, 11 Mandalay Road, Singapore, 308232, Singapore.
  • Chong Y; Colorectal Service, Department of General Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore.
  • Au-Yong A; Department of Anaesthesiology, SingHealth, Singapore, Singapore.
  • Matthews A; Department of Anaesthesiology, SingHealth, Singapore, Singapore.
  • Zaw MW; Department of Anaesthesiology, SingHealth, Singapore, Singapore.
  • Lie SA; Department of Anaesthesiology, SingHealth, Singapore, Singapore.
  • Loh L; Department of Anaesthesiology, SingHealth, Singapore, Singapore.
  • Koh D; Department of Anaesthesiology, SingHealth, Singapore, Singapore.
  • Ladlad J; Colorectal Service, Department of General Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore.
  • Khoo N; Colorectal Service, Department of General Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore.
  • Aw D; Colorectal Service, Department of General Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore.
  • Chong CXZ; Colorectal Service, Department of General Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore.
  • Ho LML; Colorectal Service, Department of General Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore.
  • Ng JL; Colorectal Service, Department of General Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore.
  • Sivarajah SS; Colorectal Service, Department of General Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore.
  • Tan WJ; Colorectal Service, Department of General Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore.
  • Foo FJ; Colorectal Service, Department of General Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore.
  • Koh FH; Colorectal Service, Department of General Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore. frederickkohhx@gmail.com.
Surg Endosc ; 37(9): 7128-7135, 2023 09.
Article em En | MEDLINE | ID: mdl-37322360
ABSTRACT

BACKGROUND:

The Erector Spinae Plane (ESP) block is a recent development in the field of regional anaesthesia and has been increasingly explored for abdominal surgeries to reduce opioid use and improve pain control. Colorectal cancer is the commonest cancer in multi-ethnic Singapore and requires surgery for curative treatment. ESP is a promising alternative in colorectal surgeries, but few studies have evaluated its efficacy in such surgeries. Therefore, this study aims to evaluate the use of ESP blocks in laparoscopic colorectal surgeries to establish its safety and efficacy in this field.

METHODS:

A prospective two-armed interventional cohort study comparing T8-T10 ESP blocks with conventional multimodal intravenous analgesia for laparoscopic colectomies was conducted in a single institution in Singapore. The decision for doing an ESP block versus conventional multimodal intravenous analgesia was made by a consensus between the attending surgeon and anesthesiologist. Outcomes measured were total intra-operative opioid consumption, post-operative pain control and patient outcome. Post-operative pain control was measured by pain score, analgesia use, and amount of opioids consumed. Patient outcome was determined by presence of ileus.

RESULTS:

A total of 146 patients were included, of which 30 patients received an ESP block. Overall, the ESP group had a significantly lower median opioid usage both intra-operatively and post-operatively (p = 0.031). Fewer patients required patient-controlled analgesia and rescue analgesia post-operatively for pain control (p < 0.001) amongst the ESP group. Pain scores were similar and post-operative ileus was absent in both groups. Multivariate analysis found that the ESP block had an independent effect on reducing intra-opioid consumption (p = 0.014). Multivariate analysis of post-operative opioid use and pain scores did not yield statistically significant results.

CONCLUSIONS:

The ESP block was an effective alternative regional anaesthesia for colorectal surgery that reduced intra-operative and post-operative opioid use while attaining satisfactory pain control.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Contexto em Saúde: 1_ASSA2030 / 2_ODS3 / 8_ODS3_consumo_sustancias_psicoactivas Problema de saúde: 1_doencas_nao_transmissiveis / 2_muertes_prematuras_enfermedades_notrasmisibles / 8_opioid_abuse Assunto principal: Neoplasias Colorretais / Laparoscopia / Bloqueio Nervoso Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Surg Endosc Assunto da revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Singapura

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Contexto em Saúde: 1_ASSA2030 / 2_ODS3 / 8_ODS3_consumo_sustancias_psicoactivas Problema de saúde: 1_doencas_nao_transmissiveis / 2_muertes_prematuras_enfermedades_notrasmisibles / 8_opioid_abuse Assunto principal: Neoplasias Colorretais / Laparoscopia / Bloqueio Nervoso Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Surg Endosc Assunto da revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Singapura
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