Efficacy of block of the erector spinal plane as a method of analgesia in the postoperative period of hysterectomy

Post-surgical analgesia in conventional hysterectomy is usually poorly planned and most of the time is only limited to a few hours after leaving the operating room. Currently, at the Misericordia Nuevo Siglo Hospital, a standardized intravenous analgesic therapy is established for newly hystere...

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Autores principales: Santiago, RG, Palmero, AM
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2023
Materias:
spinal anesthesia
analgesia
opioids
ESP
anestesia espinal
opioides
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/42804
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
id I10-R327-article-42804
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
language Español
format Artículo revista
topic spinal anesthesia
analgesia
opioids
ESP
anestesia espinal
analgesia
opioides
ESP
spellingShingle spinal anesthesia
analgesia
opioids
ESP
anestesia espinal
analgesia
opioides
ESP
Santiago, RG
Palmero, AM
Efficacy of block of the erector spinal plane as a method of analgesia in the postoperative period of hysterectomy
topic_facet spinal anesthesia
analgesia
opioids
ESP
anestesia espinal
analgesia
opioides
ESP
author Santiago, RG
Palmero, AM
author_facet Santiago, RG
Palmero, AM
author_sort Santiago, RG
title Efficacy of block of the erector spinal plane as a method of analgesia in the postoperative period of hysterectomy
title_short Efficacy of block of the erector spinal plane as a method of analgesia in the postoperative period of hysterectomy
title_full Efficacy of block of the erector spinal plane as a method of analgesia in the postoperative period of hysterectomy
title_fullStr Efficacy of block of the erector spinal plane as a method of analgesia in the postoperative period of hysterectomy
title_full_unstemmed Efficacy of block of the erector spinal plane as a method of analgesia in the postoperative period of hysterectomy
title_sort efficacy of block of the erector spinal plane as a method of analgesia in the postoperative period of hysterectomy
description Post-surgical analgesia in conventional hysterectomy is usually poorly planned and most of the time is only limited to a few hours after leaving the operating room. Currently, at the Misericordia Nuevo Siglo Hospital, a standardized intravenous analgesic therapy is established for newly hysterectomized patients. For this reason, the interest of the present work to carry out a specific regional analgesic treatment through the blockade of the spinal erector plane (ESP). The purpose of the present work eas to determine if ESP performed at the T7-T11 level reduces pain and doses of opioids and NSAIDs in the 24 hours post-surgical hysterectomy under spinal anesthesia, shortening gastrointestinal tolerance time and ambulation. Clinical-controlled, prospective, single-blind and randomized trial with informed consent and approved by CIEIS. Sixty-two patients undergoing hysterectomy under spinal anesthesia were studied: 32 received ESP block (group A), and 30 conventional intravenous analgesia (group B). The patients in group A presented stable vital signs in the 24h postoperative period, as well as a lower incidence of adverse effects (p<0.05). Pain scores were lower in group A, where only 28.1% presented EVN values greater than 4 and received rescue morphine and NSAIDs, against 100% in group B, with a significant difference. The intake in group A was 84% in the first 6h, while in group B 60% just started eating between 6-12h (p<0.05). The patients in group A wandered mostly in the first 6 hours, while in group B it predominated between 12-18h (p<0.05). ESP blockade as a postoperative analgesic method in hysterectomy under spinal anesthesia managed to reduce the levels of postoperative pain on the EVN scale, as well as the doses of non-steroidal and opioid analgesics. It was also associated with a lower incidence of adverse effects, better gastrointestinal tolerance, and earlier ambulation compared with conventional intravenous analgesia.
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2023
url https://revistas.unc.edu.ar/index.php/med/article/view/42804
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spelling I10-R327-article-428042023-10-19T21:19:05Z Efficacy of block of the erector spinal plane as a method of analgesia in the postoperative period of hysterectomy Eficacia del bloqueo del plano erector espinal como método de analgesia en el postoperatorio de la histerectomía Santiago, RG Palmero, AM spinal anesthesia analgesia opioids ESP anestesia espinal analgesia opioides ESP Post-surgical analgesia in conventional hysterectomy is usually poorly planned and most of the time is only limited to a few hours after leaving the operating room. Currently, at the Misericordia Nuevo Siglo Hospital, a standardized intravenous analgesic therapy is established for newly hysterectomized patients. For this reason, the interest of the present work to carry out a specific regional analgesic treatment through the blockade of the spinal erector plane (ESP). The purpose of the present work eas to determine if ESP performed at the T7-T11 level reduces pain and doses of opioids and NSAIDs in the 24 hours post-surgical hysterectomy under spinal anesthesia, shortening gastrointestinal tolerance time and ambulation. Clinical-controlled, prospective, single-blind and randomized trial with informed consent and approved by CIEIS. Sixty-two patients undergoing hysterectomy under spinal anesthesia were studied: 32 received ESP block (group A), and 30 conventional intravenous analgesia (group B). The patients in group A presented stable vital signs in the 24h postoperative period, as well as a lower incidence of adverse effects (p<0.05). Pain scores were lower in group A, where only 28.1% presented EVN values greater than 4 and received rescue morphine and NSAIDs, against 100% in group B, with a significant difference. The intake in group A was 84% in the first 6h, while in group B 60% just started eating between 6-12h (p<0.05). The patients in group A wandered mostly in the first 6 hours, while in group B it predominated between 12-18h (p<0.05). ESP blockade as a postoperative analgesic method in hysterectomy under spinal anesthesia managed to reduce the levels of postoperative pain on the EVN scale, as well as the doses of non-steroidal and opioid analgesics. It was also associated with a lower incidence of adverse effects, better gastrointestinal tolerance, and earlier ambulation compared with conventional intravenous analgesia. La analgesia postquirúrgica en la histerectomía convencional suele estar poco planificada y la mayoría de las veces sólo se limita a unas pocas horas de la salida del quirófano.  Actualmente, en el Hospital Misericordia Nuevo Siglo, se establece para las pacientes recién histerectomizadas una terapia analgésica endovenosa estandarizada. Por ello, el interes del presente trabajo para realizar un tratamiento analgesico especifico regional a traves del bloqueo del plano erector espinal (ESP). El objetivo del presente trabajo fue determinar si el ESP realizado a nivel T7-T11 reduce el dolor y las dosis de opioides y AINEs en las 24 horas postquirúrgicas de la histerectomía bajo anestesia raquídea, acortando tiempo de tolerancia gastrointestinal y deambulación. Ensayo clínico-controlado, prospectivo, simple ciego y randomizado con consentimiento informado y aprobado por CIEIS. Se estudiaron 62 pacientes sometidas a histerectomía bajo anestesia raquídea: 32 recibieron bloqueo ESP (grupo A), y 30 analgesia endovenosa convencional (grupo B). Las pacientes del grupo A presentaron en las 24h postoperatorias signos vitales estables, así como una menor incidencia de efectos adversos (p< 0,05). Los puntajes de dolor fueron menores en el grupo A, donde sólo el 28,1% presentaron valores EVN mayores a 4 y recibieron morfina y AINES de rescate, contra el 100% del grupo B siendo diferencia significativa. La ingesta en el grupo A fue del 84% en las primeras 6h, mientras que en el grupo B el 60% recién inició la ingesta entre las 6-12h (p<0,05). Las pacientes del grupo A deambularon mayormente en las primeras 6 horas, mientras que en el grupo B predominó entre las 12-18h (p<0,05). El bloqueo ESP como método analgésico postoperatorio en la histerectomía bajo anestesia raquídea logró reducir los niveles de dolor posquirúrgico en la escala EVN, así como las dosis de analgésicos no esteroideos y opioides. También se asoció a menor incidencia de efectos adversos, mejor tolerancia gastrointestinal y deambulación más temprana comparado con la analgesia endovenosa convencional Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2023-10-19 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/42804 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 80 (2023): Suplemento JIC XXIV Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 80 (2023): Suplemento JIC XXIV Revista da Faculdade de Ciências Médicas de Córdoba; v. 80 (2023): Suplemento JIC XXIV 1853-0605 0014-6722 spa https://revistas.unc.edu.ar/index.php/med/article/view/42804/42830 Derechos de autor 2023 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0

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