{"title":"Erector spinae plane blocks for day-case medical thoracoscopy: a pilot clinical study.","authors":"Jamie McPherson, Edward Halvey, Avinash Aujayeb","doi":"10.1515/pp-2022-0115","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Erector spinae plane (ESP) blocks are a regional anaesthetic technique used for pain relief in thoracic procedures. Our centre has recently begun using ESP blocks pre-medical thoracoscopy for analgesia.</p><p><strong>Methods: </strong>Nine patients undergoing MT from September 2021 to February 2022 were included. Opioid use and depth of required sedation was recorded. Pre and post pain scores and at home were recorded by interview and review of charts. A functional pain questionnaire was administered via telephone.</p><p><strong>Results: </strong>Average greatest depth of sedation using propofol was 1.92 (standard error of mean [SEM] 0.27), with remifentanil 2.52 (SEM 0.46). 78% required oral analgesia on day 0 post discharge. 55% required oral analgesia on post-op day 1. Patients used an average of 3.33 mg oral morphine (SEM 2.35) in hospital, and 3 mg (SEM 2) on post-op day 1. Periprocedural pain scores were 0.66 (SEM 0.27). Pain scores in recovery were 1.56 (SEM 0.76). Pain scores 3-12 h post discharge were 3.56 (SEM 0.7), while pain scores on post-op day 1 were significantly higher at 5.56 (SEM 0.90) (Figure 1). Functional pain scoring showed patients doing activities of daily living well with a good ability to breathe and cough. All felt that their pain was well controlled on the day of the procedure and at home. No complications were reported.</p><p><strong>Conclusions: </strong>ESP blocks provide good analgesia. Pain scores showed significant analgesic effect lasting several hours. The project showed pain outcomes and patient acceptability were good for the use of regional anaesthesia.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742453/pdf/","citationCount":"5","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pleura and Peritoneum","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1515/pp-2022-0115","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 5
Abstract
Objectives: Erector spinae plane (ESP) blocks are a regional anaesthetic technique used for pain relief in thoracic procedures. Our centre has recently begun using ESP blocks pre-medical thoracoscopy for analgesia.
Methods: Nine patients undergoing MT from September 2021 to February 2022 were included. Opioid use and depth of required sedation was recorded. Pre and post pain scores and at home were recorded by interview and review of charts. A functional pain questionnaire was administered via telephone.
Results: Average greatest depth of sedation using propofol was 1.92 (standard error of mean [SEM] 0.27), with remifentanil 2.52 (SEM 0.46). 78% required oral analgesia on day 0 post discharge. 55% required oral analgesia on post-op day 1. Patients used an average of 3.33 mg oral morphine (SEM 2.35) in hospital, and 3 mg (SEM 2) on post-op day 1. Periprocedural pain scores were 0.66 (SEM 0.27). Pain scores in recovery were 1.56 (SEM 0.76). Pain scores 3-12 h post discharge were 3.56 (SEM 0.7), while pain scores on post-op day 1 were significantly higher at 5.56 (SEM 0.90) (Figure 1). Functional pain scoring showed patients doing activities of daily living well with a good ability to breathe and cough. All felt that their pain was well controlled on the day of the procedure and at home. No complications were reported.
Conclusions: ESP blocks provide good analgesia. Pain scores showed significant analgesic effect lasting several hours. The project showed pain outcomes and patient acceptability were good for the use of regional anaesthesia.
目的:竖脊平面(ESP)阻滞是一种用于胸部手术疼痛缓解的区域麻醉技术。我们中心最近开始使用ESP块进行医学前胸腔镜镇痛。方法:纳入2021年9月至2022年2月接受MT治疗的9例患者。记录阿片类药物的使用和所需镇静的深度。通过访谈和查阅图表的方式记录疼痛前后和在家时的评分。通过电话进行功能性疼痛问卷调查。结果:异丙酚的平均最大镇静深度为1.92(平均标准误差[SEM] 0.27),瑞芬太尼为2.52(平均标准误差[SEM] 0.46)。78%的患者出院后第0天需要口服镇痛。55%的患者术后第1天需要口服镇痛。患者住院时平均口服吗啡3.33 mg (SEM 2.35),术后第1天平均口服吗啡3 mg (SEM 2)。围手术期疼痛评分为0.66 (SEM 0.27)。康复期疼痛评分为1.56分(SEM 0.76)。出院后3-12小时的疼痛评分为3.56 (SEM为0.7),而术后第1天的疼痛评分明显更高,为5.56 (SEM为0.90)(图1)。功能性疼痛评分显示患者日常生活活动良好,呼吸和咳嗽能力良好。所有人在手术当天和在家时都感到疼痛得到了很好的控制。无并发症报道。结论:ESP阻滞具有良好的镇痛效果。疼痛评分显示镇痛效果显著,持续数小时。该项目显示疼痛结局和患者接受程度良好的区域麻醉的使用。