Ultrasound Guided Erector Spinae Plane Block As A Postoperative Analgesia Technique For Thoracoscopy With Talc Pleurodesis

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ULTRASOUND-GUIDED ERECTOR SPINAE PLANE BLOCK AS A POSTOPERATIVE ANALGESIA TECHNIQUE FOR THORACOSCOPY WITH TALC PLEURODESIS

Author : Rita Inu00e1cio
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis ULTRASOUND-GUIDED ERECTOR SPINAE PLANE BLOCK AS A POSTOPERATIVE ANALGESIA TECHNIQUE FOR THORACOSCOPY WITH TALC PLEURODESIS by : Rita Inu00e1cio

Download or read book ULTRASOUND-GUIDED ERECTOR SPINAE PLANE BLOCK AS A POSTOPERATIVE ANALGESIA TECHNIQUE FOR THORACOSCOPY WITH TALC PLEURODESIS written by Rita Inu00e1cio and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Aims:The erector spinae plane (ESP) block is a newly described and effective interfascial plane block for thoracic and abdominal surgery.It involves injection of local anesthetic between erector spinae muscles group and thoracic transverse processes. The site of injection is distant from the pleura, major blood vessels, and spinal cord. Therefore, compared to other techniques used for thoracic analgesia, as thoracic epidural, thoracic paravertebral, and intercostal blocks, ESP block is a much safer block with relatively few contraindications and easier to perform.Methods:We present the case of a 64-year-old male patient, ASA 2, scheduled for thoracoscopy with talc pleurodesis due to recurrent primary spontaneous pneumothorax. The procedure was performed under general anesthesia and went uneventful. During PACU recovery the patient presented moderate to severe pain (NRS pain score 7/10).We performed an ultrasound-guided ESP block at T5 level with 30 mL Ropivacaine 0.375% plus adrenaline 5 ug/mL. The block was administrated successfully with observation of the solution spread between transverse process and the erector spinae muscles.Results:After 30 minutes patient NRS pain score was 1/10 with no limitation of respiratory movements. Postoperative analgesia was complemented with paracetamol 1g plus ketorolac 30 mg tid. During the 48-hour hospital stay patient presented only mild pain (maximum NRS pain score of 2/10). No opioids were used and the patient reported a very high level of satisfaction.Conclusions:This relatively simple and safe block dramatically reduced the patient NRS pain score and IV pain medication needs, mainly opioids, optimizing respiratory function ant patient mobilization.

ERECTOR SPINAE PLANE BLOCK AS REGIONAL ANESTHESIA TECHNIQUE FOR NON-INTUBATED VIDEO ASSISTED THORACIC SURGERY, A CASE SERIES

Author : Muhammad Aulia Arifahmi
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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis ERECTOR SPINAE PLANE BLOCK AS REGIONAL ANESTHESIA TECHNIQUE FOR NON-INTUBATED VIDEO ASSISTED THORACIC SURGERY, A CASE SERIES by : Muhammad Aulia Arifahmi

Download or read book ERECTOR SPINAE PLANE BLOCK AS REGIONAL ANESTHESIA TECHNIQUE FOR NON-INTUBATED VIDEO ASSISTED THORACIC SURGERY, A CASE SERIES written by Muhammad Aulia Arifahmi and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and AimsThe Erector spinae plane (ESP) block is a relatively new technique for variety of applications, from control of acute postoperative pain to chronic pain. It is an inter-fascial plane block where high volume local anesthetic is injected in a plane preferably below the erector spinae muscle. Its site of action is likely at the dorsal and ventral rami of the thoracic spinal nerves. This technique produced an extensive multi-dermatomal sensory and visceral block; however there is still limited evidence of its use for sole regional anesthesia. In this study, we report 5 cases of the ultrasound guided ESP block as regional anesthesia technique for non-intubated video assisted thoracic surgery (VATS).MethodsFive patients (aged 54 to 78 years old) diagnosed with unilateral massive pleural effusion, lung tumor, and moderate to severe restrictive COPD, underwent VATS procedure with regional anesthesia ESP block for diagnostic, pleural drainage, and lung tumor biopsy. Using ultrasound guided technique, we identified musculus erector spinae at 3cm lateral of vertebrae T5 level at seated position. Then local anesthetic 20cc of ropivacaine 0.375% were injected via needle at the plane below the musculus erector spinae, until its spread cranially to caudally could be visualized by ultrasound. We evaluate that complete block over T3 to T7 hemi-thorax is achieved within 30 minutes, and could facilitate the entire surgery. All VATS procedure in this case finished within 1 hour.ResultsWe were successfully administered regional anesthesia ESP block to four patients. They didn't require general anesthesia or additional analgesics during VATS procedure. Combined with NSAID and tramadol for 48 hours post-operative pain management, they had 0-2/10 pain numerical rating scale. However, we had to switch one patient to general anesthesia due to inadequate block result within 30 minutes evaluation.ConclusionESP block holds promise as a simple and safe alternative anesthesia technique for non-intubated VATS procedure, but it needs further research to proof its effectiveness and reliability.

Ultrasound Guided Low Thoracic Erector Spinae Plane Block for Lumbar and Sacral Spine Surgery: Case Series

Author : Feride Karacaer
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis Ultrasound Guided Low Thoracic Erector Spinae Plane Block for Lumbar and Sacral Spine Surgery: Case Series by : Feride Karacaer

Download or read book Ultrasound Guided Low Thoracic Erector Spinae Plane Block for Lumbar and Sacral Spine Surgery: Case Series written by Feride Karacaer and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and aims: Ultrasound (USG) guided Erector Spinae Plane (ESP) block is a regional anesthesia technique which can provide effective analgesia for thoracic region. But recent cases showed that this technique can be apply for lower abdominal and spinal surgeries. Lumbar spine surgery can be associated with severe postoperative pain. We aimed to present case series which show effectiveness of the USG guided lower thoracic ESP block. Methods: We report our experience with lower thoracic USG guided ESP block in six patients who underwent spinal surgery. ESP block performed bilaterally at T10 vertebra with local anesthetics 15 ml bupivacaine 0.5% and 5 ml lidocaine 2% injected via 22 gauge visible needle. We evaluated postoperative pain with 11-point numerical rating scale (NRS) and recorded rescue analgesic requirement, motor block occurrence and complications. Results: Only one patient experienced 4 point of numerical rating scale at postoperative period. Five patients decelerated 3 and below NRS. We observed that ESP block has a lower risk of complication and helpful for reducing postoperative pain for lumbar and sacral spinal surgery. Conclusion: We observed that low thoracic ESP block provide satisfactory postoperative analgesia after lumbar and sacral spine surgery without any complication and this technique did not cause motor block.

2 - ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA AFTER VATS: A SAFE AND EFFECTIVE ALTERNATIVE TO EPIDURAL ANALGESIA.

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ISBN 13 :
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Book Rating : 4.:/5 (116 download)

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Book Synopsis 2 - ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA AFTER VATS: A SAFE AND EFFECTIVE ALTERNATIVE TO EPIDURAL ANALGESIA. by :

Download or read book 2 - ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA AFTER VATS: A SAFE AND EFFECTIVE ALTERNATIVE TO EPIDURAL ANALGESIA. written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: Postoperative pain increases the morbidity and mortality after surgery. It gains importance in thoracic surgery, because the rehabilitation is essential in the initial postoperative period. For this reason, alternative analgesic techniques to the epidural are useful for cases in which epidural wasnu2019t possible.Case report: Fifty years old woman scheduled for right inferior lobectomy by VATS. In this case, epidural catheter couldnu2019t be possible due to a osteoporotic fracture at spinous process of the fifth and sixth thoracic vertebras. We performed an ESP blocks at the T5 level. About 3 centimeters lateral to the transverse process of T5 localizated the rhomboid, trapezius and erector spinal muscles. The inferior fascia of the erector muscle of the spine was located with a Tuhoy needle. We administrated 25cc of levobupivacaine 0.5% to dissect the interfascial space and placed a catheter at this level. We used analgesia by the catheter in the intraoperatory and first three postoperative days. Postoperative pain was less than 4 over 10 in VAS, during the postoperative period.Conclusions: The erector spinae plane block is a simple technique of postoperative analgesia, easily reproducible with an adequate safety profile that allows a good analgesic control in postoperative pain after videothoracoscopy.

1 - COMPARISON OF ULTRASOUND-GUIDED ERECTOR SPINAE PLANE BLOCK AND THORACIC PARAVERTEBRAL BLOCK FOR POSTOPERATIVE ANALGESIA AFTER VIDEO-ASSISTED THORACIC SURGERY: A PROSPECTIVE RANDOMIZED NON-INFERIORITY TRIAL

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Author : Taro Fujitani
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis 1 - COMPARISON OF ULTRASOUND-GUIDED ERECTOR SPINAE PLANE BLOCK AND THORACIC PARAVERTEBRAL BLOCK FOR POSTOPERATIVE ANALGESIA AFTER VIDEO-ASSISTED THORACIC SURGERY: A PROSPECTIVE RANDOMIZED NON-INFERIORITY TRIAL by : Taro Fujitani

Download or read book 1 - COMPARISON OF ULTRASOUND-GUIDED ERECTOR SPINAE PLANE BLOCK AND THORACIC PARAVERTEBRAL BLOCK FOR POSTOPERATIVE ANALGESIA AFTER VIDEO-ASSISTED THORACIC SURGERY: A PROSPECTIVE RANDOMIZED NON-INFERIORITY TRIAL written by Taro Fujitani and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and aims: The anesthetic characteristics of ultrasound-guided erector spinae plane block (ESPB) remain unclear. We conducted a study to clarify the analgesic efficacy of ESPB compared to that of thoracic paravertebral block (TPVB) for postoperative analgesia in video-assisted thoracic surgery (VATS).Methods: This study was a prospective randomized non-inferiority trial approved by the Institutional Review Board of Ehime Prefectural Central Hospital (No. 29-84, 02/03/2018). Eighty-eight patients scheduled for VATS were randomly allocated to either an ESPB or a TPVB group. Patients in both groups received continuous infusion of 0.2% levobupivacaine (8 mL/hour) after 20 mL of 0.2% levobupivacaine bolus injection. The primary outcome was postoperative numerical pain rating score (NRS) at rest 24 hours postoperatively, with a maximum acceptable difference (non-inferiority margin) between the groups as 1. We also evaluated NRS during movement, amount of rescue fentanyl used, and anesthetized dermatome number.Results: Eighty-one patients completed the study. NRS at rest was significantly lower in the TPVB group at 1, 2, and 24 hours postoperatively (respective p values = 0.018, 0.008, and 0.030). There were no significant differences in NRS during movement. The median difference in NRS at rest 24 hours postoperatively was over 1, which failed to demonstrate non-inferiority. The number of anesthetized dermatomes at parasternal regions was significantly greater in the TPVB group (p

1 - ULTRASOUND GUIDED ERECTOR SPINAE PLANE BLOCK REDUCES POSTOPERATIVE OPIOID CONSUMPTION FOLLOWING BREAST SURGERY: A RANDOMIZED CONTROLLED STUDY.

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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis 1 - ULTRASOUND GUIDED ERECTOR SPINAE PLANE BLOCK REDUCES POSTOPERATIVE OPIOID CONSUMPTION FOLLOWING BREAST SURGERY: A RANDOMIZED CONTROLLED STUDY. by :

Download or read book 1 - ULTRASOUND GUIDED ERECTOR SPINAE PLANE BLOCK REDUCES POSTOPERATIVE OPIOID CONSUMPTION FOLLOWING BREAST SURGERY: A RANDOMIZED CONTROLLED STUDY. written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: PurposePostoperative analgesia in breast surgery is a difficult and overworked issue due to extensive surgery and complex innervation of the breast. Erector spinae plane block (ESB) is a new defined regional anesthesia technique for thoracic analgesia. Although there are some case reports about ESB in breast surgeries, there is no published randomized controlled study in the literature about ESB use for this purpose. Main purpose of this study was to evaluate the analgesic effect of ultrasound guided ESB in breast surgery.MethodsFifty ASA I-II female patients, aged 25-65, who were scheduled to go under elective breast surgery were included to the study. Patients were randomized into two group as ESB and Control group. Single shot ultrasound (US) guided ESB with 20ml 0.25 % bupivacaine was done preoperatively to all patients in ESB group. Patients in both groups were provided with iv patient controlled analgesia device containing morphine for the postoperative analgesia. Morphine consumptions and visual analogue scale (VAS) scores for pain were recorded at 1st,6th, 12th and 24th hours postoperatively. ResultsThere were no significant differences between ESB and control groups for VAS scores at 1st, 6th, 12th and 24th hour (Median VAS values were 2, 2, 0, 0, and 2, 2, 1, 1 respectively). Postoperative morphine consumptions were significantly lower in ESB group compared to control group at postoperative 1st, 6th, 12th, 24th hour (Median doses of morphine consumptions were 1, 2, 3, 5 and 1, 5, 10, 16 mg respectively) (p

Continuous ERECTOR SPINAE PLANE BLOCK: First Choice in Perioperative Analgesia in Thoracotomy Surgery?

Author : Cristu00f3vu00e3o Tiago Pinto
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis Continuous ERECTOR SPINAE PLANE BLOCK: First Choice in Perioperative Analgesia in Thoracotomy Surgery? by : Cristu00f3vu00e3o Tiago Pinto

Download or read book Continuous ERECTOR SPINAE PLANE BLOCK: First Choice in Perioperative Analgesia in Thoracotomy Surgery? written by Cristu00f3vu00e3o Tiago Pinto and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Backgroud and AimsThoracic epidural analgesia are currently the first line techniques for use in managing perioperative pain follow thoracotomy (1). Regional anesthetic techniques are strongly recommended primarily to reduce opioid use and the related adverse effects, including hypoventilation, sedation, nausea, and vomiting (2).In this way, continuous erector spinae plane (ESP) block is growing popularity because of its simplicity, safe and lesser side effects (1,2).We aim to present the result of the analgesic efficacy ofcontinuous ultrasound-guided ESP block in two cases of thoracotomy surgery.Case Report:65-year-old woman, presented for right inferior lobectomy (adenocarcinoma) and a 49-year-old woman, presented for left superior lobectomy (adenocarcinoma). Combined anesthesia (Balanced general anesthesia + continuous ESP) was performed. Before induction, the ultrasound-guided unilateral continuous ESP block was performed at the level of T5. 30 milliliters of ropivacaine 0,375% were administered.The multimodal approach for postoperative analgesia was: programmed intermittent mandatory boluses through the ESP catheter of ropivacaine 0,2% 8 ml/h + paracetamol 1g 8/8h + ketorolac 30mg 12/12h. Rescue analgesia with tramadol 100mg.The worst pain was 4 (numeric scale) 3 and 5 hours after surgery, respectively. At this time they both do tramadol 100mg. Beside this they donu00b4t need more rescue analgesia in the first 48 hours.ConclusionPain after thoracotomy can be difficult to control with a multimodal analgesia. Furthermor, thoracic epidural analgesia has potentially serious complications. Recently, ESP block has increased acceptance because it is a safe thoracic block with minor complications. With this two cases authors had shown that continuous ESP block provides effective post-operative analgesia follow thoracotomy with excellent pain control inside multimodal analgesic program with low opioids requirements.1- Forero M, Adhikary SD, Lopez H, et al. The Erector Spinae Plane Block: A novel analgesic technique in thoracic neuropatic pain. Regional Anesthesia and Pain Medicine. 2016 Sep u2013 Oct 41; 5: 621-27.2 - Forrero M, Rajarathinam M, Adhikary S, et Chin KJ. Continuous Erector Spinae Plane Block for Rescue Analgesia in Thoracotomy After Epidural Failure: ACase Report. . A & A Case Reports. MAY 15TH, 2017; 8(10):254u2013256.

MODIFIED ERECTOR SPINAE BLOCK FOR THORACIC SURGERIES: PRELIMINARY REPORT OF THE CASES.

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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis MODIFIED ERECTOR SPINAE BLOCK FOR THORACIC SURGERIES: PRELIMINARY REPORT OF THE CASES. by :

Download or read book MODIFIED ERECTOR SPINAE BLOCK FOR THORACIC SURGERIES: PRELIMINARY REPORT OF THE CASES. written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background:Erector Spinae Plane (ESP) block is a novel technique inwhich local anesthetic (LA) is injected between the erector spinae muscle and transverse process under ultrasound guidance. It has been used as a postoperative analgesia method in many surgical procedures. The mechanism of action is not clear. There are well-described anatomical gaps in the intertransverse connective tissue that might explain how LA can pass from the ESP into the para-vertebral space. Although it is efficient, in real life there is block failure/lack of efficiency that tells us there might be things to consider about the block. We would like to present our modified technique (ESP-3) aimed more reliable block.Cases: We perform ESP-3 for 6 patients (1-breast surgery with fleb, 4-thoracoscopic pleurodesis and 1-lobectomy). Blocks performed at sitting position. A lineer-ultrasound probe placed longitudinal parasagittal orientation. After transverse process (TP) identified an 22G-echogenic needle (Braun-StimuplexUltra360) is inserted in-plane caudal-to-cranial approach. The needle tip made contact to TP and 10 ml of Local anesthetic (LA-Bupivacaine) is given to the facial plane. Then the needle moves from the most proximal part of the TP, pass intertransverse ligament and 15 ml of LA is injected just above the superior costotransverse ligament.Results:Before the end of the surgeries Non-steroid anti-inflammatory drug and paracetamol was given. None of the patients complained about the pain. No complication was recorded.Conclusion:Facial plane blocks are promising. They can be as effective as epidurals. With our modified ESP technique, we hypothesized a more consistent and reliable block can be achieved.

CONTINUOUS ERECTOR SPINAE PLANE BLOCK WITH EPIDURAL CATHETER FOR POSTu2011OPERATIVE ANALGESIA FOLLOWING THORACIC SURGERIES: A CASE SERIES

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Author : ALI RAZA KHAN
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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis CONTINUOUS ERECTOR SPINAE PLANE BLOCK WITH EPIDURAL CATHETER FOR POSTu2011OPERATIVE ANALGESIA FOLLOWING THORACIC SURGERIES: A CASE SERIES by : ALI RAZA KHAN

Download or read book CONTINUOUS ERECTOR SPINAE PLANE BLOCK WITH EPIDURAL CATHETER FOR POSTu2011OPERATIVE ANALGESIA FOLLOWING THORACIC SURGERIES: A CASE SERIES written by ALI RAZA KHAN and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background & Aims:Erector spinae plane block (ESPB) is a novel regional analgesia technique for thoracic and abdominal surgeries. It can be employed for analgesia as an alternative to epidural block in patients presenting for thoracic surgeries. ESPB provides adequate analgesia, is technically easier to perform, and safer due to lower risk of serious complications as compared to epidural block. We have illustrated this by presenting a case series of thoracic surgeries in which an ESPB catheter was used for postoperative analgesia. We reviewed our SOP regarding use of continuous ESPB use for thoracic surgeries.Methods:35 patients (ASA-III/IV) who underwent thoracic surgery (VATS, thoracotomy) under GA were included. Ultrasound-guided, 16-G epidural catheter was inserted at T5 level cephalo-caudally. 30 mL of 0.25% bupivacaine in ESPB administered prior to incision supplemented with Tramadol (1 mg/kg IV). Postoperatively ESPB infusion was started at 10 mL/h of 0.1% bupivacaine. The dose and catheter management in rooms/ward was done by anesthesia technicians. The outcomes assessed were number of hours in PACU stay, VAS 2 hourly in PACU and then 8 hourly in rooms/ward), safety profile and number of days of catheter in situ. Rescue analgesia was Tramadol 0.75 mg/kg IV SOS, Ketorolac 0.5 mg/kg IV BD (if not contraindicated) and Paracetamol 1 g IV TDS. The authors certify that appropriate consent were obtained from the patients and their identity is not been disclosed.Continuous Erector Spinae Plane block with epidural catheter for post-operative analgesia following thoracic surgeries.A case seriesResults:Patient stay in PACU was for 8u00b14 hours. Mean VAS 2 hourly in PACU was 3u00b12 while mean VAS 8 hourly in room/ward was 1u00b11. None of the patients had hypotension necessitating vasopressor support, and the catheter remained in situ for 4u00b12 days. 34.2% (N=12) patients who experienced VAS 5, required supplemental analgesia.Discussion:TEA and PVB are mostly chosen as the first line regional analgesic techniques in thoracic surgeries for the pain management.[1, 2] When there is a contraindication or failure of these blocks, intercostal nerve block remained as an alternative but necessitating multiple injections. ESP block can serve as an alternative either as a single dose or as a continuous catheter based infusion for post-thoracotomy pain. Forero et al.[3] demonstrated ESPB as rescue analgesia in thoracotomy after a failed epidural. They revealed comparable pain score between TEA and ESP block until 12 h postextubation. The VAS scores remained to be persistently u22644 until 48 h in either of the group.Conclusions:Our case series reflects that ESPB provides adequate postoperative analgesia with no hemodynamic compromise in patients undergoing thoracic surgeriesReferences1 Romero A, Et. al. The state of the art in preventing postt-horacotomy pain. Semin Thorac Cardiovasc Surg. 2013;25:116u201324.2 Yeung JH, Et al. Paravertebral block versus thoracic epidural for patients undergoing thoracotomy. Cochrane Database Syst Rev. 2016;2:CD009121.3 Forero M, Et al. Continuous ESPB for rescue analgesia in thoracotomy after epidural failure. A Case Rep. 2017;8:254u20136.

ERECTOR SPINAE PLANE BLOCK (ESP) FOR POSTOPERATIVE ANALGESIA FOR MASTECTOMY TOTAL RADICAL: CASE REPORT

Author : Rueda Viviana
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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis ERECTOR SPINAE PLANE BLOCK (ESP) FOR POSTOPERATIVE ANALGESIA FOR MASTECTOMY TOTAL RADICAL: CASE REPORT by : Rueda Viviana

Download or read book ERECTOR SPINAE PLANE BLOCK (ESP) FOR POSTOPERATIVE ANALGESIA FOR MASTECTOMY TOTAL RADICAL: CASE REPORT written by Rueda Viviana and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: To describe 50-year-old female patient, , a weight of 62 kg, with an 8-year history of a mass in the right breast which has undergone rapid progressive growth, involving the entire breast, over the past 7 months, diagnosed as a phyllodes tumor. Simple right mastectomy with axillary lymph node dissection and pectoralis major fascia resection were performed under general anesthesia. Ultrasound-guided erector spinae plane block was performed for postoperative analgesia, with excellent response up to 18 hours following the procedure.The patient was placed on left lateral decubitus and, following asepsia and anti-sepsis, T6 to T7 and right paravertebral ultrasound was performed using a highfrequency linear probe, to identify the anatomy (Figure 2) Bupivacaine with 0.25% epinephrine and 0.5% lidocaine was administered (total volume 20mL), achieving satisfactory erector spinae hydrodissection. Assessment 4hours later found an area of anesthesia comprised by the right anterior hemithorax and axillary region and anesthesia from T4 to T12 in the posterior region (Figure 3) Pain assessment was performed over a 30-hour period using the analog visual scale. Based on our findings, ESP block may be recommendedas an option or adjunct for pain management.

Ultrasound-guided Erector Spinae Plane (US- ESP) Block Associated to Dexmetomidine Cooperative Sedation for Anesthetic Management in Breast Cancer Surgery: a Case Report

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Author : Giordano Carolina
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis Ultrasound-guided Erector Spinae Plane (US- ESP) Block Associated to Dexmetomidine Cooperative Sedation for Anesthetic Management in Breast Cancer Surgery: a Case Report by : Giordano Carolina

Download or read book Ultrasound-guided Erector Spinae Plane (US- ESP) Block Associated to Dexmetomidine Cooperative Sedation for Anesthetic Management in Breast Cancer Surgery: a Case Report written by Giordano Carolina and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Aims:Ultrasound-guided Erector Spinae Plane Block (US-ESPB) is a recently described regional block technique for anesthesia and analgesia of the chest wall. Dexmetomidine (DEX) is an u03b1-2 agonist that can provide cooperative sedation during surgery. We reported a case of US-ESPB associated to intraoperative DEX sedation in a patient undergoing breast cancer surgery.Methods:A 42 years-old patient, ASA 2, was scheduled to undergo quadrantectomy with sentinel lymph node biopsy. Before surgery, we performed a US-ESPB and 20 ml of 0,5% Ropivacaine were injected using a 90 mm needle (Temena u00ae) deep to the erector spinae muscle and superficial to T5 transverse processes. The patient received intravenously DEX in a loading dose of 1 mcg/kg over 15 minutes, followed by an infusion of 0,4 mcg/kg/h and oxygen (4 l/min) was administered by facemask.Results:We obtained adequate surgical anesthesia and a good quality postoperative analgesia. Moreoverer, DEX infusion provided cooperative sedation during surgery (Ramsay 3) without causing respiratory depression of the patient. Only 3 g of acetaminophen were administered postoperatively. No complications were recorded.Conclusions:This case report suggested that US-ESPB associated to intraoperative DEX cooperative sedation could represent a reliable strategy for anesthetic management in breast surgery.

The Ultrasound-guided Erector Spinae Plane Block Allows Opioid Free Anesthesia in the Modified Radical Mastectomy with Axillary Dissection: a Pilot Study about 14 Cases

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Author : El Ahmadi Brahim
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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis The Ultrasound-guided Erector Spinae Plane Block Allows Opioid Free Anesthesia in the Modified Radical Mastectomy with Axillary Dissection: a Pilot Study about 14 Cases by : El Ahmadi Brahim

Download or read book The Ultrasound-guided Erector Spinae Plane Block Allows Opioid Free Anesthesia in the Modified Radical Mastectomy with Axillary Dissection: a Pilot Study about 14 Cases written by El Ahmadi Brahim and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Aims:the modified radical mastectomy with axillary dissection is usually carried out under balanced general anesthesia using opiates, it is a source of moderate to severe postoperative acute pain. Opioid-free anesthesia (OFA) aims to reduce the undesirable effects of opioids while ensuring optimal anesthesia and analgesia perioperatively. we report 14 cases of ultrasound-guided Erector Spinae Plane Block (ESPB) to perform surgery using OFA.Methods:We recruited patients presenting no contraindications to the anesthetic technique. The OFA protocol included a general anesthesia with no opioids and an ultrasound-guided erector spinae plane block with bupivacaine at T4 level. Prior to incision, patients received a bolus of Ketamine, Ketoprofen, dexamethasone IV . Maintenance of anesthesia was performed by sevoflurane at 1 MAC. In case of haemodynamic repercussions related to nociception, a bolus of fentanyl at 1 u03bcg / kg was administered.ResultsAfter the approvel of the ethic comitee we included 14 consenting patients. Hemodynamic variations were all less than 20% of baseline. No patient had any intraoperative opiate injection. Upon waking, patients had a median visual analogical scale (VAS) less than 3. During the first 24 hours, the VAS was less than 3. Only one patient received a bolus of 3 mg morphine IV as part of the catch-up postoperative analgesia. After 24 h, all patients had no resting pain.Conclusions:OFA, is used to avoid short-term and long-term adverse effects of opioids, such as: nausea, postoperative hyperalgesia, chronic pain and tumor recurrence. The ESPB allows to practice anesthesia and analgesia in a safe way.

THE ERECTOR SPINAE PLANE BLOCK AS AN ANALGESIC REGIONAL TECHNIQUE IN ACUTE POST-SURGICAL PAIN CONTROL IN LUMBAR SURGERY. PRELIMINARY FINDINGS OF A RANDOMIZED TRIAL

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Author : MARTINA VENTIMIGLIA
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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis THE ERECTOR SPINAE PLANE BLOCK AS AN ANALGESIC REGIONAL TECHNIQUE IN ACUTE POST-SURGICAL PAIN CONTROL IN LUMBAR SURGERY. PRELIMINARY FINDINGS OF A RANDOMIZED TRIAL by : MARTINA VENTIMIGLIA

Download or read book THE ERECTOR SPINAE PLANE BLOCK AS AN ANALGESIC REGIONAL TECHNIQUE IN ACUTE POST-SURGICAL PAIN CONTROL IN LUMBAR SURGERY. PRELIMINARY FINDINGS OF A RANDOMIZED TRIAL written by MARTINA VENTIMIGLIA and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND AND AIM: Inadequate pain control affects morbidity and hospitalization length. Post-operative pain is commonly managed with opioids with important side effect. Recent data has shown that the novel erector spinae plane (ESP) block, can be employed as a safe regional analgesic technique for acute post-surgical and chronic neuropathic pain.The aim of the present study was to investigate the capacity of ESP block to provide successful post-operative pain management undergoing spinal surgery. METHODS: 29 patients undergoing open lumbar decompression surgery were randomized in two groups. ESP group (n=12) received ESP block with 0,5% levobubivacaina 20 ml, the control group (n=17) no intervention was performed and postoperative analgesia was achieved with IV morphine plus ketorolac. The primary outcome was represented by postoperative numerical rate scale (NRS) score at various time periods during the first 24 hours following surgery. The secondary outcomes included opioid consumption, rescue analgesia and opioid related side effects. The study protocol was approved by the local review board. RESULTS: Compared with control group, the NRS score of ESP block patients did not show any statistically significant differences in the measured time periods. Twenty-four-hour opioid consumption in group control was significantly higher compared to group ESP (30u00b12.6 mg and 10u00b12.08 mg, p

COMPARISON OF ULTRASOUND GUIDED ERECTOR SPINAE PLANE BLOCK AND QUADRATUS LUMBORUM TYPE II BLOCK IN LAPAROSCOPIC CHOLECYSTECTOMY

Author : Tulgar Serkan
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis COMPARISON OF ULTRASOUND GUIDED ERECTOR SPINAE PLANE BLOCK AND QUADRATUS LUMBORUM TYPE II BLOCK IN LAPAROSCOPIC CHOLECYSTECTOMY by : Tulgar Serkan

Download or read book COMPARISON OF ULTRASOUND GUIDED ERECTOR SPINAE PLANE BLOCK AND QUADRATUS LUMBORUM TYPE II BLOCK IN LAPAROSCOPIC CHOLECYSTECTOMY written by Tulgar Serkan and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Erector Spinae Plane Block (ESPB) is a recently described regional anesthetic technique used in upper abdominal surgeries such as laparoscopic cholecystectomy (LC). Quadratus Lumborum Block Type II (QLB2) has also been reported for postoperative analgesia in LC. Herein, we compared the effectiveness of ESPB and QLB-2 in providing postoperative analgesia in patients undergoing these surgeries.This prospective, randomized, controlled, double-blinded study included two groups ( ESPB and QLB-2) with 40 patients each (ASA 1-2-3, aged >18 years due to undergo LC under general anesthesia.) All patients underwent the same general anesthesia regimen. All blocks were performed bilaterally at the end of surgery with the application of 20 ml of local anesthetic mixture for each side. Ultrasound guided ESPB was performed in the lateral position (Th8-9) and QLB-2 in the exaggerated lateral decubitus position. Numeric rating scale, morphine consumption via patient controlled analgesia device were noted for the first 24 hours (NCT03869801).In our preliminary results, each group includes 20 patients. There was no difference between demographic data or type of surgery. There was no difference in NRS score at any hour between the groups; accept than the first hour. Morphine consumption during the first 24 hours were statistically higher in the QLB-2 group compared to ESPB group (7u00b13.60 mg and 4u00b12.25 mg, respectively- ). p:0.046While QLB-2 and ESPB have similar effect on pain scores, ESPB decrease the requirement for analgesic agents in LC when compared to a QLB-2 group.

ERECTOR SPINAE PLANE BLOCK: WHEN PARAVERTEBRAL BLOCK IS NOT AN OPTION

Author : Daniel da Melo
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis ERECTOR SPINAE PLANE BLOCK: WHEN PARAVERTEBRAL BLOCK IS NOT AN OPTION by : Daniel da Melo

Download or read book ERECTOR SPINAE PLANE BLOCK: WHEN PARAVERTEBRAL BLOCK IS NOT AN OPTION written by Daniel da Melo and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Aims:The accomplishment of paravertebral block requires integrity of the parietal pleura and it should be avoided in cases of pleural empyema due to the risk of dissemination of the infection to the central nervous system.We present a case in which the erector spinae plane block (ESPB) was chosen as ananalgesic alternative to videothoracoscopic pulmonary decortication.Methods:75 years old, male, 64kg, hypertensive and smoker, with pleural empyema was scheduled to perform videothoracoscopic pulmonary decortication. Considering the contraindications to execute the paravertebral block, the anesthetic team decided to perform an ESPB for postoperative analgesia.At the end of the surgical procedure, with patient still in lateral decubitus, under general anesthesia, ultrasound guided ESPB was performed at T5 level with 20 mL of Ropivacaine 0.375% plus 50 mcg of Clonidine.ResultsAfter extubation, the patient awoke without complaints and was referred to intensive care unit (ICU). After 3 hours in ICU, the patient assigned grade 2 on numerical scale of pain intensity. The first request for complementary analgesia occurred after 5 hours in ICU.Conclusions:In patients with contraindication to paravertebral block due to parietal pleural damage or empyema, ESPB represents a regional anesthesia alternative in postoperative analgesia for thoracic surgeries.

ULTRASOUND GUIDED ERECTOR SPINAE PLANE BLOCK FOR SURGICAL ANESTHESIA IN POSTERIOR THORACIC LIPOMA EXCISION: A CASE REPORT

Author : Tayfun Aydu0131n
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis ULTRASOUND GUIDED ERECTOR SPINAE PLANE BLOCK FOR SURGICAL ANESTHESIA IN POSTERIOR THORACIC LIPOMA EXCISION: A CASE REPORT by : Tayfun Aydu0131n

Download or read book ULTRASOUND GUIDED ERECTOR SPINAE PLANE BLOCK FOR SURGICAL ANESTHESIA IN POSTERIOR THORACIC LIPOMA EXCISION: A CASE REPORT written by Tayfun Aydu0131n and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and aims: Ultrasound guided erector spinae plane block (ESP) has been recently reported as an effective method for surgical anesthesia in minor surgery. We aim to present a case of lipoma excision from the posterior thoracic wall, operated under ESP block.Methods: The patient was 38-year-old female who had a mass located at left posterior thoracic wall, 4-5 cm lateral to the neuraxial midline between T3 and T5 skin dermatomes (Figure 1a). The patient was sedated with 2 mg midazolam. We performed ultrasound (US) guided erector spinae plane block at T4 dermatome in sitting position using a high frequency ultrasound probe. We administered 35 ml local anesthetic drug mixture (20 ml 0.5% Marcaine+5ml 2% Lidocaine+10 ml normal saline) between the T4 transverse process and erector spinae muscle (figure 1b). Results: After 20 minutes, we checked the operation site with pinprick test and confirmed complete sensorial loss to pain at the surgical site. The operation started uneventfully and lasted for 40 minutes. The patient was comfortable during the operation and there was no need for additional sedatives or analgesics (Figure 1c). 12 cm transverse incision was performed and 6x6 cm lipoma was excised (Figure 1d).Conclusions: Our case demonstrated that sufficient surgical anesthesia at posterior thoracic region is possible with performance of ESPB. In our case, possible risks of general anesthesia and endotracheal intubation have been avoided and the patient was discharged on the same day without additional analgesic requirement.

ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA IN LAPAROSCOPIC HYSTERECTOMY U2013 A CASE REPORT

Author : Lara Ribeiro
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA IN LAPAROSCOPIC HYSTERECTOMY U2013 A CASE REPORT by : Lara Ribeiro

Download or read book ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA IN LAPAROSCOPIC HYSTERECTOMY U2013 A CASE REPORT written by Lara Ribeiro and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA IN LAPAROSCOPIC HYSTERECTOMY u2013 A CASE REPORTJ. Veiga1, R. Silva1, P. Almeida1, S. Oliveira1, L. Ribeiro1.1Hospital de Braga, Department of Anesthesia, Braga, Portugal.Background and Aims:The Erector Spinae Plane Block (ESP) was first described in 2016, and, since then, there has been growing interest and research about its potential as regional anesthetic/analgesic technique. With the present case we are interested in exploring the efficacy of ESP block as a postoperative analgesic method for laparoscopic hysterectomy.Methods:We describe a case of a 47-year-old female patient, ASA I scheduled for elective laparoscopic hysterectomy. A bilateral ultrasound-guided ESP block at T8 level was performed before general anesthesia induction. The anesthetic solution we used consisted of 20 ml Ropivacaine 0,5% (on each side). Systemic analgesia with Paracetamol 1g and Ketorolac 30mg was performed during the surgery and prescribed for 24h and after that u201con demandu201d.ResultsProcedure and recovery were uneventful with the patient experiencing good analgesia (NRS pain scale 0-2/10) 12 hours after block performance. No u201con demandu201d pain medication was requested by the patient during the hospital admission. The patient experienced no nausea or vomiting, was mobilized easily 6 hours after the block and was discharged 36 hours later.Conclusions:The ESP block applied to abdominal laparoscopic surgery has a relatively limited literature, particularly in laparoscopic hysterectomy. This is the reason we believe every new case is a valuable contribution. In this case report, the use of ESP block performed preoperatively dramatically reduced the amount of IV pain medication.The overall result was increased satisfaction of the patient, avoidance of opioid use and fast recovery.