Ultrasound-guided erector spinae plane block improves analgesia after laparoscopic hepatectomy: a randomised controlled trial.

Laparoscopic hepatectomy is associated with trauma and severe pain. We examined whether bilateral, ultrasound-guided, single-injection erector spinae plane block (ESPB) could improve on postoperative analgesia compared with patient-controlled intravenous analgesia in patients undergoing laparoscopic hepatectomy. Fifty adults were randomly allocated to receive patient-controlled intravenous analgesia alone or combined with bilateral single-injection ESPB (ropivacaine 0.5%, 15 ml on each side). Primary outcome was resting pain scores at 3 h postoperatively assessed with visual analogue scale (VAS). Secondary outcomes included VAS scores at rest and during movement at 6, 12, 16, 20, 24, 48, and 72 h postoperatively; use of intraoperative opioids; postoperative rescue analgesia; sleep quality; time of first ambulation; ESPB-related complications; and ropivacaine concentration in plasma. The ESPB group showed lower resting VAS scores at 3 h postoperatively (mean [standard deviation]), 2.0 (0.5) vs 4.3 (0.7), P<0.001, and significantly lower scores at rest and during movement at 6-24 h postoperatively. The ESPB group showed lower intraoperative opioid use, lower consumption of rescue analgesia within 72 h postoperatively, and better sleep quality. ESPB subjects began to ambulate 10 h earlier than control subjects. None of the ESPB subjects showed ESPB-related complications, and analysis of a subset of subjects showed that ropivacaine concentrations in plasma decreased gradually over time. Compared with patient-controlled intravenous analgesia only, preoperative ultrasound-guided erector spinae plane block can improve postoperative analgesia, reduce opioid demand, and accelerate recovery in patients undergoing laparoscopic hepatectomy. Chinese Clinical Trial Registry ChiCTR1900020961.

Huang X ，Wang J ，Zhang J ，Kang Y ，Sandeep B ，Yang J ... -  《-》

Ultrasound-Guided Techniques for Postoperative Analgesia in Patients Undergoing Laparoscopic Sleeve Gastrectomy: Erector Spinae Plane Block vs. Quadratus Lumborum Block.

Ashoor TM ，Jalal AS ，Said AM ，Ali MM ，Esmat IM ... -  《-》

Effect of erector spinae plane block with different doses of dexmedetomidine as adjuvant for ropivacaine on the postoperative quality of recovery after video-assisted thoracoscopic lobectomy surgery: a randomized controlled trial.

Guo Y ，Wang J ，Jiang P ，Wang D ，Fan W ，Yang X ... -  《BMC Anesthesiology》

The efficacy of lumbar erector spinae plane block for postoperative analgesia management in patients undergoing lumbar unilateral bi-portal endoscopic surgery: a prospective randomized controlled trial.

The efficacy and reliability of erector spinae plane block (ESPB) in posterior open lumbar spine surgery has been demonstrated; however, few randomized controlled trials of lumbar ESPB (L-ESPB) in lumbar unilateral bi-portal endoscopic (UBE) surgery have been reported. A total of 120 patients, aged 18 to 65 (who underwent elective lumbar UBE surgery under general anesthesia and exhibited an American Society of Anesthesiologists physical status of I to III) were randomly assigned in a 1:1 ratio to the ESPB group and the Control group. Ultrasound(US)-guided unilateral single-shot 0.25% ropivacaine L-ESPB was performed in the ESPB group, but not in the control group. Postoperative analgesic strategy for all patients: patient controlled intravenous analgesia (PCIA, diluted and dosed with fentanyl alone) was initiated immediately after surgery combined with oral compound codeine phosphate and ibuprofen sustained release tablets (1 tablet containing ibuprofen 200 mg and codeine 13 mg, 1 tablet/q12h) commenced 6 h postoperatively. We collected and compared patient-centred correlates intraoperatively and 48 h postoperatively. The primary outcomes were intraoperative and postoperative opioid consumption and postoperative quality of recovery-15 (QoR-15) scores. Compared to the control group (n = 56), the ESPB group (n = 58) significantly reduced intraoperative remifentanil consumption (estimated median difference - 280 mcg, 95% confidence interval [CI] - 360 to - 200, p < 0.001, power = 100%); significantly reduced fentanyl consumption at 24 h postoperatively (estimated median difference - 80mcg, 95%[CI] - 128 to - 32, p = 0.001, power = 90%); and significantly enhanced the QoR-15 score at 24 h postoperatively (estimated median difference 11, 95%[CI] 8 to 14, p < 0.001, power = 100%). Compared to the control group, the ESPB group enhanced the resting numeric rating scale (NRS) score up to 8 h postoperatively, and the active movement NRS score up to 4 h postoperatively. The incidence of postoperative nausea and vomiting (PONV) (p = 0.015, power = 70%), abdominal distension (p = 0.024, power = 64%), and muscular calf vein thrombosis (MCVT) (p = 0.033, power = 58%) was lower in the ESPB group than in the control group. Moreover, the occurrence of L-ESPB related adverse reactions was not found herein. US-guided L-ESPB reduces intraoperative and 24 h postoperative opioid consumption and improves patients' QoR-15 scores at 24 h postoperatively. L-ESPB can be safely and effectively utilized in lumbar UBE surgery. Chinese Clinical Trial Registry, ChiCTR2200061908 , date of registration: 10/07/2022. Registry URL.

Zhao D ，Wang H ，Liu X ，Gao Z ，Sun C ，Zhang Q ... -  《BMC Anesthesiology》

Comparison of erector spinae plane block and serratus anterior plane block for postoperative analgesia in uniportal thoracoscopic lobectomy: a randomized controlled trial.

Wu W ，Xu H ，Chen X ，He W ，Shi H ... -  《BMC Anesthesiology》