EFFECT OF BILATERAL ULTRASOUND–GUIDED ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA IN CESAREAN SECTION- A PROSPECTIVE RANDOMIZED SINGLE-BLIND CONTROLLED STUDY

Abstract

Abstract

Background: Regional analgesia techniques like Transversus Abdominis Plane (TAP) block, Quadratus Lumborum (QL) block and erector Spinae Plane Block (ESP)have shown their efficacy in postoperative pain management in various surgeries.

Purpose of the Study: Studies showing the efficacy of ESP block in cesarean section was limited in our population. Hence, we conducted this study to analyze the analgesic efficacy erector Spinae Plane block after Cesarean section.

Methods: In this prospective, randomized controlled study, 60 patients scheduled for elective cesarean section was randomized to receive bilateral ultrasound ‑ guided ESP block with 20 ml 0.25% Bupivacaine (n = 30) in Group A or standard intravenous analgesia-in Group B (n=30) postoperatively. The primary outcome assessed was Visual analog scale (VAS) scores for pain in 48 hours and the secondary outcomes assessed were time for the first request to analgesia, total postoperative rescue analgesia consumption and incidence of adverse effects. Statistical analysis was done using the International Business Machines Statistical package for social sciences Statistics-23 software (IBM SPSS).

Results: The VAS score in Group A (ESP group) was significantly less (P<0.05) at 2, 4, 6 and 8 hours. The time taken for first request of analgesia was significantly higher in Group A (8.3h) than in Group B (3.6h) (P<0.05). The total postoperative rescue tramadol analgesia used was significantly lower in Group A 63.3 mg than in group B (100 mg) (P<0.05). Group A had a higher incidence of bradycardia in 4 patients than in Group B 0 patients (P<0.05).

Conclusion: ESP block is a promising approach for lowering pain scores and extending the time to first request for analgesia with reduced total postoperative analgesia consumption in lower segment cesarean section.