Book Synopsis 5 - Ultrasound-guided Bilateral Erector Spinae Plane Block Versus Intrathecal Morphine for Analgesia in Living Donors for Liver Transplantation: A Randomized Non-inferiority Trial by :
Download or read book 5 - Ultrasound-guided Bilateral Erector Spinae Plane Block Versus Intrathecal Morphine for Analgesia in Living Donors for Liver Transplantation: A Randomized Non-inferiority Trial written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Preoperative ITM administration is an effective analgesic method in living donor hepatectomy, but is associated with adverse effects, including postoperative nausea, vomiting, and pruritus. The ESP block has been shown to provide effective postoperative analgesia after various laparoscopic abdominal surgeries. We therefore sought to determine the analgesic effects of ESP block in living liver donors undergoing laparoscopic right hepatectomy. We hypothesized that it would provide noninferior postoperative analgesia compared to ITM and reduce postoperative nausea/vomiting and pruritus.Methods: Fifty-four patients scheduled for pure laparoscopic right donor hepatectomy were randomly assigned to one of two groups: an ESP group (n=27) and an ITM group (n=27). Patients in the ESP group received preoperative bilateral single-injection ESP blocks at the level of the T8 transverse process with an injection of 20 mL 0.5% ropivacaine with 5mcg/mL epinephrine on each side). Patients in the ITM group received a preoperative intrathecal injection of 400 u00b5g morphine sulfate. The primary outcome was the pain score at rest 24 hours after surgery as assessed by an 11-point numeric rating scale. The predetermined noninferiority limit was 1. Incidences of postoperative nausea/vomiting and pruritus were assessed.Results: The mean resting pain score 24 hours after surgery was 2.5u00b11.0 in the ESP group and 1.3u00b11.1 in the ITM group (p
