Efficacy of Bilateral Erector Spinae Plane Block using Bupivacaine and Ropivacaine for Postoperative Analgesia following Lumbar Spine Surgeries- A Randomised Clinical Study
Introduction: Erector Spinae Plane Block (ESPB) is a safe and simple technique that provides favourable pain relief and reduced postoperative analgesia consumption. Both bupivacaine and ropivacaine have been used in ESPB and have been found to provide good postoperative analgesia. Aim: To compa...
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| Autores principales: | , , , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
JCDR Research and Publications Private Limited
2021
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/3aab4558735744b7884adefdd0ab76c8 |
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| Sumario: | Introduction: Erector Spinae Plane Block (ESPB) is a safe and
simple technique that provides favourable pain relief and reduced
postoperative analgesia consumption. Both bupivacaine and
ropivacaine have been used in ESPB and have been found to
provide good postoperative analgesia.
Aim: To compare the efficacy of bupivacaine and ropivacaine
in bilateral ESPB for postoperative pain relief in lumbar spine
surgeries.
Materials and Methods: The randomised clinical trial was
conducted from July 2019 to June 2020. The study included 60
patients posted for lumbar spine surgeries which were divided
randomly into two groups. Group A patients (n=30) received
ESPB using 0.25% bupivacaine and group B patients (n=30)
received ESPB with 0.2% ropivacaine after induction of GA
with endotracheal intubation. Visual Analog Scale (VAS) score,
time to first rescue analgesic, haemodynamic changes and any
complications were monitored at regular time intervals in the
postoperative period. For quantitative data, a parametric test
(Student’s t-test) and a non parametric test (Mann-Whitney U
test) were used. The Chi-square test was used for parametric
analysis of qualitative data.
Results: The mean age (in years) in Group A was 36.93±9.47
and Group B was 38.00±8.43. There was significant difference in
mean VAS scores between bupivacaine and ropivacaine groups
at 4 hours (4.03±0.93 vs 4.57±0.94; p-value=0.033) and at 6 hours
(5.63±0.55 vs 5.26±0.64; p-value=0.021), postoperatively. The
mean time to first rescue analgesic requirement was significantly
higher in bupivacaine group than ropivacaine group (6.33±1.3
vs 5.27±0.97 hours: p-value=0.001). Patients in both the groups
remained haemodynamically stable throughout the study period.
No significant change in saturation, Electrocardiogram (ECG)
changes, postoperative nausea and vomiting was observed in
any of the two groups.
Conclusion: The ESPB with bupivacaine 0.25% provides better
and prolonged analgesic effect postoperatively as compared to
ropivacaine 0.2% with acceptable haemodynamic stability |
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