ABSTRACT
Erector spinae plane block (ESPB) is one of the commonly preferred regional anesthesia techniques in the recent past for various procedures including spine surgeries. The main advantages of ESPB are the ease of performing the technique and the lesser chance of complications. Many studies have proven that ESPB plays an important role in reducing perioperative opioid consumption, postoperative nausea and vomiting, as well as the length of stay in the hospital. Thus it has been adopted as one of the measures for the enhanced recovery after surgery (ERAS) protocol. Nevertheless, the role of bi-level ESPB and a continuous catheter technique are the major research gaps and thus require further research in this population. The details of these two methods are discussed elaborately here.
Subject(s)
Anesthesia, Conduction , Cholecystectomy, Laparoscopic , Humans , Network Meta-Analysis , Risk FactorsABSTRACT
Background Surgical transverse abdominis plane (TAP) block has been studied in various surgeries. However, its role particularly in the form of continuous infusion in comparison to epidural infusion in open gynecological surgeries remains unknown. Hence, this study was taken up. Methodology Sixty patients were assigned to either of the two groups: continuous epidural (Group E) or continuous infusion in the surgical TAP (Group S). The primary outcomes were visual analog scale (VAS) pain scores and rescue analgesic requirements. Postoperative complications such as nausea/vomiting, hypotension, and bradycardia were also assessed. Results Mean pain scores were significantly lesser in Group E. However, 80% (24) of Group E and 50% (15) of Group S did not require rescue analgesia, which was not statistically significant. Adverse effects did not differ significantly between the two groups. Conclusions The efficacy of the continuous surgical TAP block is similar to a continuous epidural. Therefore, it can be considered in settings with limited resources and expertise or in cases of contraindications for an epidural.
