The Effect of Ultrasound-Guided Erector Spinae Plane Block on Postoperative Opioid Consumption and Respiratory Recovery in Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Study.

IF 2.9 3区医学 Q1 SURGERY Obesity Surgery Pub Date : 2024-11-06 DOI:10.1007/s11695-024-07576-9

Arzu Karaveli, Serdar Kaplan, Ali Sait Kavakli, Mehmet Nuri Kosar, Burhan Mayir

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Abstract

Background: The aim of this prospective, randomized, controlled study was to evaluate the effect of ultrasound (US)-guided bilateral erector spinae plane (ESP) block on postoperative opioid consumption and respiratory recovery in patients with obesity undergoing laparoscopic sleeve gastrectomy (LSG).

Methods: The study was conducted on 40 patients scheduled for LSG. The patients were randomly allocated into either the ESP block group or the control group. The US-guided bilateral ESP block was performed preoperatively. The control group received no intervention.

Results: Postoperative median [IQR] tramadol consumption was significantly lower in the ESP block group [150.0 [100-200] mg vs 450.0 [400-500] mg, p < 0.0001]. Postoperative spirometric variables were significantly impaired in both groups, compared with preoperative variables (p < 0.0001). Intraoperative median [IQR] fentanyl consumption was 200.0 [200-200] µg in the ESP block group, and 350.0 [300-400] µg in the control group (p < 0.0001). Postoperative mean pain scores at rest and during movement were significantly lower in the ESP block group, at all time points (p < 0.05). In terms of mean arterial PH, Horowitz ratio, and PaCO₂, there was no statistically significant difference between the groups (p > 0.05). None of the patients experienced postoperative respiratory adverse events and/or block-related complications.

Conclusions: US-guided bilateral ESP block significantly reduced both intraoperative and postoperative analgesic consumptions and provided effective postoperative pain control for patients with obesity undergoing bariatric surgery. Following bariatric surgery, all patients' postoperative pulmonary functions deteriorated. The effect of US-guided bilateral ESP block on postoperative respiratory recovery could not be clearly demonstrated. Randomized controlled studies with a larger patient population are necessary.

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腹腔镜袖状胃切除术中超声引导下脊索肌平面阻滞对术后阿片类药物消耗和呼吸恢复的影响：随机对照研究

背景：这项前瞻性、随机对照研究旨在评估超声（US）引导下的双侧竖脊肌（ESP）阻滞对接受腹腔镜袖带胃切除术（LSG）的肥胖患者术后阿片类药物消耗和呼吸恢复的影响：研究对象为 40 名计划接受腹腔镜袖带胃切除术（LSG）的患者。方法：研究对象为 40 名计划接受腹腔镜袖状胃切除术（LSG）的患者，患者被随机分配到 ESP 阻滞组或对照组。术前在 US 引导下进行双侧 ESP 阻滞。结果：结果：ESP阻滞组的术后曲马多用量中位数[IQR]明显低于对照组[150.0 [100-200] mg vs 450.0 [400-500] mg，p 2]，但两组间差异无统计学意义（p > 0.05）。所有患者术后均未出现呼吸系统不良事件和/或阻滞相关并发症：结论：US引导下的双侧ESP阻滞可显著减少术中和术后镇痛药的用量，为接受减肥手术的肥胖症患者提供有效的术后疼痛控制。减肥手术后，所有患者的术后肺功能都有所恶化。US 引导下的双侧 ESP 阻滞对术后呼吸恢复的影响尚不明确。有必要对更多患者进行随机对照研究。

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来源期刊

Obesity Surgery 医学-外科

CiteScore

5.80

自引率

24.10%

发文量

567

审稿时长

3-6 weeks

期刊介绍： Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions. Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.