Журнал «Медицина неотложных состояний» №2(97), 2019
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Ultrasound guided bilateral erector spinae plane block for acute post-surgical pain in patients after thoracic trauma
Авторы: D.V. Dmytriiev, E.O. Glazov
National Pirogov Memorial Medical University, Vinnytsia, Ukraine
Рубрики: Медицина неотложных состояний
Разделы: Медицинские форумы
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Background. The purpose was to examine the analgesic efficacy of bilateral erector spinae plane (ESP) block compared with conventional treatment for pain after thoracic trauma. Materials and methods. 27 patients with thoracic trauma were divided into 2 groups. Patients in group 1 (ESP block group, n = 13) received ultrasound-guided bilateral ESP block with 3 mg/kg of 0.375% ropivacaine before anesthesia induction at the T6 transverse process level. Patients in group 2 (acetaminophen and morphin group, n = 14) received acetaminophen (15 mg/kg every 6 hours — maximum 1 g) and morphine (10 mg every 8 hours) intravenously in the postoperative period. The primary study outcome was to evaluate pain at rest using an 10-point numeric rating scale (NRS). Mann — Whitney U-test was used for comparing NRS scores. Results. The postoperative pain level after extubation and duration of analgesia during which NRS was < 4 of 10 was compared between the groups. The median pain score at rest after extubation in group 1 was 0 of 10 until hour 6, 3 of 10 at hour 8, and 4 of 10 at hours 10 and 12 postextubation. These were significantly less in comparison with group 2 (p = 0.0001). Patients in group 1 had a significantly higher mean duration of analgesia (10.18 ± 0.28 hours), during which NRS was < 4 of 10, compared with group 2 (5.04 ± 0.12 hours) (p = 0.0001). Conclusions. ESP block safely provided significantly better pain relief at rest for longer duration as compared to intravenous acetaminophen and morphine.