Background and Aims Laparotomic surgeries are still associated will severe pain. Numerous studies have shown erector spinae plane block(ESPB) efficacy at Th8 level for laparoscopic surgeries. In open abdominal surgeries, data are still spared. We report our initial experience with ESPB performed at Th8 and Th10 levels for postoperative analgesia after conventional cholecystectomies.
Methods 19 patients were randomly assigned into two groups. Laparotomic cholecystectomies were performed.
After surgery we performed right side ESPB either at Th8(n=12) or Th10(n=7). All patients received Bupivacaine 1.5mg/kg in 40 ml saline for ESPB and Dexamethasone 0.1 mg/kg intravenously(i/v). Analgesia with paracetamol and dexketoprofene were performed. Pain and opioid consumption were evaluated 1, 8, 24 hours after surgery.
Results We notice that pain scores at 8 and 24h were significantly lower if block was performed at Th10 level, results are shown in figure 1. Correlation was significantly negative between level of block and pain scores after 8 and 24 hours [r=-0.5;p=0.03,r=-0.75;p=0.0002].
Nine patients 1h after surgery reported no pain and had no NRS>4 for the next 24h, 42%(N=3) had block at Th8 and 86%(N=6) at Th10 level; p=0.06. Nine patients experienced pain (NRS 5–6) in drainage area. Of those 66%(N=8) who had block at Th8 level and only 14%(N=1) at Th10 level; p=0.03.There were no complications of ESPB.
Conclusions Our preliminary results show that ESPB might be effective component of multimodal analgesia after open cholecystectomies. However, block performed at Th10 level showed higher efficacy in terms of average pain intensity and pain in drainage area; further studies are needed to straighten this finding.
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