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103 Analgesic effect of erector spinae plane block after caesarean section: a randomized controlled trial
  1. A Dostbil1,
  2. I Ince1,
  3. E Yamak Altınpulluk2,
  4. MF Perez3,
  5. U Peksoz1,
  6. G Cimilli4,
  7. K Kasali5,
  8. C Atalay1,
  9. O Ozmen1,
  10. T Sahin4 and
  11. EP Yılmaz4
  1. 1Ataturk University School of Medicine, Department of Anesthesiology and Reanimation, Erzurum, Turkey
  2. 2Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Anaesthesiology and Reanimation, Istanbul, Turkey
  3. 3Hospital Universitario de Móstoles,Department of Anesthesia, Madrid, Spain
  4. 4Ataturk University School of Medicine, Department of Obstetrics and Gynecology, Erzurum, Turkey
  5. 5Ataturk University School of Medicine, Department of Biostatistics, Erzurum, Turkey


Background and Aims We hypothesized that bilateral erector spinae plane block applied from the transverse process of T9 who underwent elective cesarean section could provide effective postoperative analgesia.

Methods Fifty parturients who were in 38–42 gestational weeks who were scheduled to undergo elective cesarean section under spinal anesthesia were included in the study.Group I (n=25) was categorized as the group in which spinal anesthesia alone (SA) was performed,Group II (n=25) was categorized as the group in which SA+ESP block was performed.All patients were given a solution containing 7 mg isobaric bupivacaine+15µg fentanyl intrathecally through spinal anesthesia.The SA+ESP group,the bilateral ESPB was performed at the level T9 with 20 ml 0.25% bupivacaine+2 mg dexamethasone immediately after the operation.Total fentanyl consumption in 24 hrs,visual analogue scale (VAS)score for pain,time to the first analgesic request were evaluated postoperatively.

Results The total fentanyl consumption in 24 hours was statistically significantly lower in the SA+ESP group than the SA group (279±242.99µg vs. 423.08±212.55µg, respectively, p= 0.003). The first analgesic requirement time was statistically significantly shorter in the SA group than the SA+ESP group (150.20±51.83min vs.197.60±84.49min, respectively, p= 0.022). Postoperative VAS scores at 4th, 8th, and 12th h at rest were statistically significantly lower in group SA+ESP than group SA (p=0.004,p=0.046,p=0.044, respectively).VAS scores during the postoperative 4th,8th, and 12th h cough was statistically significantly lower in group SA+ESP than group SA (p=0.002, p=0.008, p=0.028, respectively).

Conclusions Ultrasound-guided bilateral ESP provided adequate postoperative analgesia and significantly decreased postoperative fentanyl consumption in patients having Caesarean section. Also, it has a longer analgesia time than the control group, and it has been shown to delay the first analgesic requirement.

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