Erector spinae plane block vs non-steroidal anti-inflammatory drugs for severe renal colic pain: A pilot clinical feasibility study.

AIM: Ultrasound-guided plane blocks are increasingly used in the multi-modal analgesic concept for reducing opioid consumption. The present study was conducted to compare the analgesic effect of intravenous non-steroidal anti-inflammatory drugs (NSAIDs) and erector spinae plane (ESP) block in renal colic patients. METHODS: In this prospective randomised study, 40 patients with renal colic pain were randomly assigned into two groups: Group NSAID (n = 20) received an intravenous infusion of 50 mg of dexketoprofen trometamol and Group ESP (n = 20) received ultrasound-guided ESP block with 30 ml 0.25% bupivacaine at the T8 level. The pain severity of patients was assessed using the visual analogue scale (VAS) at baseline, 5, 15, 30, 45 and 60 minutes after intervention. Opioid consumption, patient satisfaction and side effects were recorded. RESULTS: In the ESP group, the VAS scores were significantly lower than the NSAID group at 5, 15, 30, 45 and 60 minutes after the procedure (P < .001). Opioid consumption was significantly higher in the NSAID group compared with the ESP group (10/20 vs 0/20, respectively; P < .001). Patient satisfaction was significantly higher in the ESP group (P < .001). CONCLUSIONS: ESP block can be an alternative, efficient and safe method for the relief of acute renal colic pain.

Sedoanalgesia Versus Infraclavicular Block for Closed Reduction of Pediatric Forearm Fracture in Emergency Department: Prospective Randomized Study.

OBJECTIVE: Procedural sedoanalgesia is commonly used in pediatric patients in the emergency department (ED) for interventional procedures, diagnosis, and treatment. However, this method causes serious systemic complications, such as respiratory and cardiac depression. To minimize these complications, ultrasound-guided regional anesthesia methods have been used in recent years. We aimed to compare the use of procedural sedoanalgesia (PSA) and infraclavicular block (ICB) in the pain management of pediatric patients who underwent closed reductions of forearm fractures. MATERIALS AND METHODS: This prospective, randomized, clinical study included patients aged 3 to 15 years who presented to the ED with forearm fractures. The patients were divided into 2 groups: the procedural sedoanalgesia group (group PSA, n = 30) and ultrasound-guided ICB group (group ICB, n = 30). Pain scores of the patients were evaluated using the Wong-Baker FACES Scale before and during the procedure. Pain scores and parental and operator satisfaction were compared between the groups. RESULTS: There was no statistical significance in terms of demographic data. The pain scores observed during the procedures were significantly higher in the group PSA than in the group ICB (3.07 ± 1.55 vs 0.47 ± 0.86, respectively; P < 0.001). The parental and operator satisfaction of the ICB group was significantly higher than that of the PSA group (P < 0.001). CONCLUSIONS: Ultrasound-guided ICB is a safe and effective method in the management of pain during closed reduction of forearm fracture in pediatric patients in EDs. It can be used safely in emergency rooms and has a high level of both parental and operator satisfaction.

Can ultrasound-guided infraclavicular block be an alternative option for forearm reduction in the emergency department? A prospective randomized study.

OBJECTIVE: Ultrasound-guided infraclavicular nerve block (IB) has become a well-established method in several outpatient procedures; however, its use in emergency departments (EDs) remains limited. The aim of this study was to compare procedural sedation and anlagesia (PSA) and IB in the pain management for patients who underwent forearm fracture reduction in the ED. METHODS: This prospective randomized study included 60 patients aged 18 to 65 years, who visited the ED with forearm fractures. They were randomly divided into two groups: Group PSA (n=30) and Group IB (n=30). The pain scores of patients were evaluated before and during the procedure with the visual analog scale. Complications and patient and operator satisfaction levels were recorded. RESULTS: There was no difference between the two groups in terms of demographic characteristics. The median (interquartile range) pain scores observed during the procedures were significantly higher in Group PSA than in Group IB (4 [4-6] vs. 2 [0-2], respectively; P<0.001). Patient and operator satisfaction levels were significantly higher in Group IB (P<0.001). Oxygen desaturation was statistically higher in Group PSA than in Group IB (40.00% vs. 3.33%, respectively; P=0.002). CONCLUSION: IB was an effective alternative for reducing pain and increasing patient satisfaction in ED patients undergoing forearm fracture reduction.