Erector spinae plane block combined with local infiltration analgesia for total hip arthroplasty: A randomized, placebo controlled, clinical trial.

Autor: Lennon MJ; Department of Anesthesia, Hollywood Private Hospital, Monash Avenue, Perth, WA 6009, Australia; Department of Anesthesia, Sir Charles Gairdner Hospital, Nedlands, Perth, WA 6009, Australia. Electronic address: mjlennon007@gmail.com., Isaac S; The Joint Studio, Orthopedic Surgery, Hollywood Medical Centre, Nedlands, WA 6009, Australia., Currigan D; Department of Anesthesia, Hollywood Private Hospital, Monash Avenue, Perth, WA 6009, Australia; Department of Anesthesia, Sir Charles Gairdner Hospital, Nedlands, Perth, WA 6009, Australia., O'Leary S; Acute Pain Service, Hollywood Private Hospital, Monash Avenue, Perth, WA 6009, Australia., Khan RJK; The Joint Studio, Orthopedic Surgery, Hollywood Medical Centre, Nedlands, WA 6009, Australia; Faculty of Science and Engineering, Curtin University, Bentley, WA 6102, Australia; School of Medicine, University of Notre Dame, 9 Mouat Street, Fremantle, WA 6959, Australia., Fick DP; The Joint Studio, Orthopedic Surgery, Hollywood Medical Centre, Nedlands, WA 6009, Australia; Faculty of Science and Engineering, Curtin University, Bentley, WA 6102, Australia; School of Medicine, University of Notre Dame, 9 Mouat Street, Fremantle, WA 6959, Australia.
Jazyk: angličtina
Zdroj: Journal of clinical anesthesia [J Clin Anesth] 2021 May; Vol. 69, pp. 110153. Date of Electronic Publication: 2020 Dec 07.
DOI: 10.1016/j.jclinane.2020.110153
Abstrakt: The erector spinae plane block is an emerging analgesic technique, which is gaining popularity for a large number of procedures. The majority of publications are at the thoracic level and almost all indicate some benefit to patients. However, there have been relatively few randomized controlled trials and even fewer studies at the lumbar level. The aim of this study was to assess whether the erector spinae plane block at the lumbar level would confer early analgesic benefits and improve the quality of recovery in patients undergoing elective unilateral primary hip arthroplasty. Sixty-four patients were randomized to receive an erector spinae plane block at the third lumbar vertebra with either 30milliliters (ml) of 0.2% ropivacaine or 30 ml of 0.9% saline. The patient, anesthetist and assessor were blinded to allocation. The primary outcome was pain on movement at 6 h (numeric rating scale 0-10) with a reduction of 2 points considered clinically significant. Secondary outcomes included quality of recovery (QoR-15 score), mobilization and length of stay. In this study there was no appreciable analgesic benefit to adding an erector spinae plane block to patients who already receive neuraxial blocks, local anesthetic infiltration and oral multimodal analgesia for elective primary total hip arthroplasty. Both groups were found to have relatively low pain scores and a high quality of recovery with no significant difference in mobilization or length of stay.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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