COMPARATIVE RANDOMIZED STUDY BETWEEN ERECTOR SPINAE PLANE BLOCK AND SINGLE SHOT EPIDURAL BLOCK FOR POSTOPERATIVE PAIN MANAGEMENT IN ABDOMINAL SURGERY
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Keywords
Erector spinae plane block, Pain, open abdominal hysterectomy, Epidural, Neuraxial analgesia
Abstract
Background: The epidural block is a well-established method for providing effective analgesia during abdominal surgeries. The erector spinae plane block (ESPB), a field block technique, has demonstrated promising outcomes in different surgical procedures. This study compares the two techniques in open abdominal hysterectomy surgeries, focusing on pain management following surgery, the time to the 1st analgesic request, total consumption of morphine following surgery, hemodynamic stability during operation.
Methodology: This double-blinded randomized controlled investigation included 60 female cases, divided into 2 groups. The epidural group received a single-shot epidural block under ultrasound guidance using twenty milliliters of 0.25 percent bupivacaine. The ESPB group underwent bilateral single-shot erector spinae plane blocks, also guided by ultrasound, with twenty milliliters of 0.25 percent bupivacaine administered on each side. Data collected included levels of pain following surgery, time to the 1st analgesic request, total consumption of morphine following surgery, hemodynamics during surgery, and any adverse events.
Results: The time to the 1st analgesic request has been significantly prolonged in the ESPB group (10.71±3.58 hours) compared to the epidural group (6.53±2.19, *P_value less than 0.001). Mean consumption of morphine was also lower in the ESPB group (3.84±0.61mg vs. 7.06±1.87mg; *P-value less than 0.001). While the visual analogue scale scores for pain were lower in the ESPB group, fewer patients in the ESPB group experienced intraoperative hypotension and bradycardia. Conclusion: Compared to a single-shot epidural block, ESPB offers prolonged analgesia after surgery , reduced consumption of opioid, and greater hemodynamic stability through surgery in open abdominal hysterectomy surgeries.
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Hend Mostafa Ahmed Abosaifa
Department of Anesthesiology, Intensive care and pain management, Faculty of Medicine for Girls. Al-Azhar University.
Nashwa Mohammed Ibrahiem
Department of Anesthesiology, Intensive care and pain management, Faculty of Medicine for Girls. Al-Azhar University.
Gihan Eissa Zahran
Department of Anesthesiology, Intensive care and pain management, Faculty of Medicine for Girls. Al-Azhar University.