Cholecystitis, Chronic, Regional Anesthesia Morbidity
Conditions
Brief summary
Laparoscopic cholecystectomy, one of the most commonly performed abdominal surgeries, is a gold standard therapy for surgical treatment of benign biliary diseases. Erector spinae plane block (ESPB) was first presented in 2016 as the treatment of neuropathic pain in a case series, and gained popularity very quickly due to its safety applicability, and effect on both the visceral and parietal component of pain by providing paravertebral, transforaminal and epidural spread. Preoperative application of ESPB has taken its place as a part of multimodal analgesia in laparoscopic cholecystectomy cases over time and has been shown to reduce postoperative pain scores and opioid consumption and to improve quality of recovery scores. However, there is no data regarding the use of ESPB in the postoperative period as a rescue therapy.
Interventions
PROCEDUREErector Spina Plane Group
ESPB had been applied postoperatively: from T8 level, 20mL bupivacaine %0,5 + 5ml %2 lidocaine was applied.
PROCEDUREIV analgesic intervention
IV analgesics had been applied: All meperidine boluses are dosed in line with the pain intensity as follows: 10 mg if NRS \> 3, 20 mg if NRS \> 5, 30 mg if NRS \> 8. If NRS score is not reduced at least 20% when compared to prior one, additional meperidine bolus is applied.
Sponsors
Istanbul Saglik Bilimleri University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Inclusion criteria
* Patients undergoing laparoscopic cholecystectomy * Patients with NRS\>3 scores in the PACU
Exclusion criteria
* ASA \> 2 * Violation of standart protocol (anesthesia and analgesia) * application of ESPB preoperatively * age \> 65 * Surgery duration \>90min or \<45min
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| effect of ESPB applied postoperatively on the meperidine consumption in PACU | 1 HOUR | As part of the standardized perioperative care management, the pain intensity is evaluated with the numeric pain rating scale (NRS). If the NRS is \> 3 meperidine bolus or ESPB is applied in line with the patients' selection and the patients are evaluated in every 5 min in terms of their NRS scores until NRS \< 4 is achieved. If NRS score is not reduced at least 20% when compared to prior one, additional meperidine bolus is applied. All meperidine boluses are dosed in line with the pain intensity as follows: 10 mg if NRS \> 3, 20 mg if NRS \> 5, 30 mg if NRS \> 8. NRS scores and meperidine boluses applied are recorded on the PACU follow-up form. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| effect of ESPB applied postoperatively on numeric rating scores in PACU | 1 HOUR | As part of the standardized perioperative care management, the pain intensity is evaluated with the numeric pain rating scale (NRS). If the NRS is \> 3 meperidine bolus or ESPB is applied in line with the patients' selection and the patients are evaluated in every 5 min in terms of their NRS scores until NRS \< 4 is achieved. If NRS score is not reduced at least 20% when compared to prior one, additional meperidine bolus is applied. All meperidine boluses are dosed in line with the pain intensity as follows: 10 mg if NRS \> 3, 20 mg if NRS \> 5, 30 mg if NRS \> 8. NRS scores and meperidine boluses applied are recorded on the PACU follow-up form. |
Countries
Turkey (Türkiye)
Outcome results
None listed