Efficacy of Lumbar Erector Spinae Plane Block for Postoperative Analgesia in Hip Arthroplasty Patients– A Prospective Case Series
Vol 3 | Issue 2 | July-December 2022 | Page 98-101 | Bharati A. Adhye, Sandeep M. Diwan, Rajeev Joshi, Parag K. Sancheti
DOI: 10.13107/ijra.2022.v03i02.062
Authors: Bharati A. Adhye [1], Sandeep M. Diwan [1], Rajeev Joshi [1], Parag K. Sancheti [2]
[1] Department of Anesthesiology, Sancheti Hospital, Pune, Maharashtra, India.
[2] Department of Orthopaedics, Sancheti Hospital, Pune, Maharashtra, India.
Address of Correspondence
Dr. Bharati A. Adhye,
Chief Anaesthesiologist, Department of Anesthesiology, Sancheti Hospital, Pune, Maharashtra, India.
E-mail: bharatiadhye@gmail.com
Abstract
The Thoracic Erector spinae plane block (ESPB) has been incorporated in multimodal analgesia protocols since 2016. In a series of 20 Total Hip Arthroplasty (THA) patients, done under spinal anaesthesia, we studied the efficacy of Lumbar Erector spinae plane block (L-ESPB) for post operative analgesia. L-ESPB was administered at L4 with Ropivacaine 0.2% (0.4 mg/kg). Time to first analgesia (TTFA) request (mean 15.03 hours) and total opioid consumption in first 24 hours (mean 27.5 mg Tramadol) was noted. A median NRS at TTFA was 3.5. Our study demonstrates L-ESPB as an effective alternate technique for postoperative analgesia in THA patients.
Keywords: Lumber ESP block, Hip Arthroplasty
References
1. Singh R, Bajaj JK, Singh D. Comparison of psoas compartment block and epidural block for postoperative analgesia in hip surgeries. Astrocyte 2018;4(4):221.
2. Capdevila X, Macaire P, Dadure C, Choquet O, Biboulet P, Ryckwaert Y, et al. Continuous psoas compartment block for postoperative analgesia after total hip arthroplasty: new landmarks, technical guidelines, and clinical evaluation. Anesth Analg. 2002;94(6):1606-1613.
3. Grant CR, Checketts MR. Analgesia for primary hip and knee arthroplasty: the role of regional anaesthesia. Contin Educ Anaesthesia, Crit Care Pain. 2008;8(2):56-61.
4. Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The erector spinae plane block: a novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med. 2016;41(5):621-627.
5. Tsui BCH, Fonseca A, Munshey F, McFadyen G, Caruso TJ. The erector spinae plane (ESP) block: a pooled review of 242 cases. J Clin Anesth. 2019;53:29-34.
6. Chin KJ, Adhikary S Das, Forero M. Erector spinae plane (ESP) block: A new paradigm in regional anesthesia and analgesia. Curr Anesthesiol Rep. 2019;9(3):271-280.
7. Tulgar S, Ermis MN, Ozer Z. Combination of lumbar erector spinae plane block and transmuscular quadratus lumborum block for surgical anaesthesia in hemiarthroplasty for femoral neck fracture. Indian J Anaesth. 2018;62(10):802.
8. Tulgar S, Senturk O. Ultrasound guided Erector Spinae Plane block at L-4 transverse process level provides effective postoperative analgesia for total hip arthroplasty. J Clin Anesth. 2017;44:68.
9. Ahiskalioglu A, Tulgar S, Celik M, Ozer Z, Alici HA, Aydin ME. Lumbar erector spinae plane block as a main anesthetic method for hip surgery in high risk elderly patients: initial experience with a magnetic resonance imaging. Eurasian J Med. 2020;52(1):16.
10. Tulgar S, Aydin ME, Ahiskalioglu A, De Cassai A, Gurkan Y. Anesthetic techniques: focus on lumbar erector spinae plane block. Local Reg Anesth. 2020;13:121.
11. González SJDL, Pomés J, Prats-Galino A, Gracia J, Martínez-Camacho A, SalaBlanch X. Estudio anatómico de la distribución del volumen administrado tras bloqueo en el plano profundo del erector espinal a nivel lumbar. Rev Esp Anestesiol Reanim. 2019;66(8):409-416.
12. R. Shane T, Matthew R, Levin B.S., Marios Loukas, Eric A. Potts, Aaron A. Cohen-Gadol. Anatomy and landmarks for the superior and middle cluneal nerves: application to posterior iliac crest harvest and entrapment syndromes. J. Neurosurg: Spine/ Volume13/ September 2010
13. Diwan S, Nair A. Lumbar erector spinae plane block obtunding knee and ankle reflexes. Saudi J Anaesth. 2021;15(2):222.
How to Cite this Article: Adhye BA, Diwan SM, Joshi R, Sancheti PK | Efficacy of Lumbar Erector Spinae Plane Block for Postoperative Analgesia in Hip Arthroplasty Patients– A Prospective Case Series | International Journal of Regional Anaesthesia | July-December 2022; 3(2): 98-101. |