Background and Aims Open nephrectomy is considered leading to intense postoperative pain. A multimodal approach combining different analgesia methods with intravenous and regional anesthesia regimens to maximize effectiveness is essential and a challenge for the anesthesiologist. Erector Spinae Plane Block (ESPB) is a new technique, which is performed by deposing the local anesthetic in the fascial plane at the tip of the transverse process of the vertebra. The local anesthetic exerts its effect on the ventral and dorsal ramus of the spinal nerve. Therefore, we present a case series of 5 patients where we evaluated the effect of ESPB on postoperative pain in nephrectomy
Methods 5 patients where scheduled for open nephrectomy. Induction in anaesthesia was performed with Propofol 2mg/kg, Fentanyl 1mcg/kg and Rocuronium 1mg/kg. After 3 minutes of pre-oxygenation with 100% oxygen tracheal intubation was performed. Anaesthesia was maintained using desflurane 7% and 45%/55% oxygen/air mixture. All patients received 1gr Paracetamol and 0,1–0,2mg/kg morphine (iv). At the end of the surgery ESPB was performed under ultrasound guidance and 20 ml of 0,375% ropivacaine was administered at T9 level.
Results 5 patients ASA II-III where scheduled for open nephrectomy, mean age 70,2±3,7. Mean surgical time was 121,25±19,6. All patients were Hemodynamically stable and SpO2 was at normal range. Mean VAS score was 1±1,6 the first 12h and 3,6±1,4 the first 24h after surgery. 2 patients recieved tramadol postoperative. There was no episode of postoperativelynausea or vomit.
Conclusions ESPB seems to be a promising analgesic technique for management of postoperative pain after open nephrectomy