Dual erector spinae plane block for complex traumas of upper and lower limb: an opioid reduction strategy—a case series

IF 0.5 Q4 ANESTHESIOLOGY Ain-Shams Journal of Anesthesiology Pub Date : 2023-10-21 DOI:10.1186/s42077-023-00380-0
Sandeep Diwan, Abhijit Nair, Bharati Adhye, Ganesh Bhong, Parag Sancheti
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Abstract

Abstract Background Patients with polytrauma (fractures of the humerus and the femur) require concurrent operative fixation. Pain originating from multiple operative sites leads to increasing doses of opioid-based analgesia, which has detrimental effects in the form of longer hospital stays, higher costs, and increased mortality. Case presentation In twelve patients with humerus and femur fractures, a cervical erector spinae plane block (ESPB) at the level of T1 and a lumbar ESPB at the level of L2 were administered with a catheter and continuous infusion technique for postoperative analgesia. None of these patients required opioids in the postoperative period. The catheters were removed after 48 h. Conclusions A dual ESPB can be used successfully in patients with multiple injuries by appropriately selecting the level of intervention, and opioid-sparing analgesia can be effectively delivered to these patients.
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双竖脊机脊柱平面阻滞治疗上肢和下肢复杂创伤:阿片类药物减少策略-一个病例系列
背景多发创伤(肱骨和股骨骨折)患者需要同时手术固定。来自多个手术部位的疼痛导致阿片类镇痛剂剂量增加,其有害影响包括住院时间延长、费用增加和死亡率增加。在12例肱骨和股骨骨折患者中,采用导管和持续输注技术,在T1水平置入颈竖脊平面阻滞(ESPB),在L2水平置入腰椎ESPB,用于术后镇痛。这些患者在术后均不需要阿片类药物。结论适当选择干预水平,双ESPB可成功应用于多发损伤患者,并可有效地为患者提供保留阿片类药物的镇痛。
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