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Analgesic Strategies for Urologic Surgery in the Context of an Enhanced Recovery after Surgery Protocol: A Retrospective Study Comparing Erector Spinae Palne Block versus Transversus Abdominis Plane Block
Micali, M.; Cucciolini, G.; Bertoni, G.; Gandini, M.; Lattuada, M.; Santori, G.; Introini, C.; Corradi, F.; Brusasco, C. Analgesic Strategies for Urologic Videolaparoscopic or Robotic Surgery in the Context of an Enhanced Recovery after Surgery Protocol: A Retrospective Study Comparing Erector Spinae Plane Block versus Transversus Abdominis Plane Block. J. Clin. Med.2024, 13, 383.
Micali, M.; Cucciolini, G.; Bertoni, G.; Gandini, M.; Lattuada, M.; Santori, G.; Introini, C.; Corradi, F.; Brusasco, C. Analgesic Strategies for Urologic Videolaparoscopic or Robotic Surgery in the Context of an Enhanced Recovery after Surgery Protocol: A Retrospective Study Comparing Erector Spinae Plane Block versus Transversus Abdominis Plane Block. J. Clin. Med. 2024, 13, 383.
Micali, M.; Cucciolini, G.; Bertoni, G.; Gandini, M.; Lattuada, M.; Santori, G.; Introini, C.; Corradi, F.; Brusasco, C. Analgesic Strategies for Urologic Videolaparoscopic or Robotic Surgery in the Context of an Enhanced Recovery after Surgery Protocol: A Retrospective Study Comparing Erector Spinae Plane Block versus Transversus Abdominis Plane Block. J. Clin. Med.2024, 13, 383.
Micali, M.; Cucciolini, G.; Bertoni, G.; Gandini, M.; Lattuada, M.; Santori, G.; Introini, C.; Corradi, F.; Brusasco, C. Analgesic Strategies for Urologic Videolaparoscopic or Robotic Surgery in the Context of an Enhanced Recovery after Surgery Protocol: A Retrospective Study Comparing Erector Spinae Plane Block versus Transversus Abdominis Plane Block. J. Clin. Med. 2024, 13, 383.
Abstract
Regional anesthesia in postoperative pain management have developed in recent years, especially with the advent of fascial plane blocks. This study aims to compare the ultrasound-guided bilateral erector spinae plane block (ESPB) versus bilateral transversus abdominis plane block (TAPB) on postoperative analgesia after laparoscopic or robotic urologic surgery. This was a retrospective observational study; 97 patients (ESPB-group) received bilateral ultrasound-guided ESPB with 20 mL of ropivacaine 0.375% plus 0.5 mcg/kg of dexmedetomidine in each side at the level of T7-T9, and 93 patients (TAPB-group) received bilateral ultrasound-guided TAPB with ropivacaine 0.375% or 0.25%. The primary outcome was post-operative numeric rating scale (NRS) pain score, which was significantly lower in the ESPB-group on postoperative days 0, 2, and 3 (p=0.012, p=0.016 and p=0.004). Concerning the secondary outcomes, consumption of ropivacaine was significantly lower in ESPB-group (p<0.001) and the total amount of analgesic rescue doses was significantly lower in the ESPB-group than TAPB-group in postoperative days from 2 to 4 (1 vs 3, p>0.001). Incidence of postoperative nausea and vomiting was higher in the TAPB-group and no block related complications were observed. We conclude that ESPB provide better postoperative pain control with less consumption of local anesthetic and less total rescue analgesic therapies.
Medicine and Pharmacology, Anesthesiology and Pain Medicine
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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