Scholarlink

Background <p>Open radical nephrectomy often results in significant acute postoperative pain. Regional anesthesia offers an alternative analgesic approach in these situations. This study aims to assess and compare the effectiveness of ultrasound-guided rhomboid intercostal sub-serratus (RISS) block with Erector Spinae Plane Block (ESPB) in patients undergoing open radical nephrectomy.</p> Methods <p>This randomized clinical trial included 42 patients scheduled for open radical nephrectomy (RN). Patients were randomly assigned to one of two groups: the ESPB Group (<i>n</i> = 21), which received an ESPB with 30&#xa0;ml of bupivacaine 0.25%, or the RISS Group (<i>n</i> = 21), which received a RISS block with 30&#xa0;ml bupivacaine 0.25%. Total morphine consumption was set as the primary outcome while pain scores, perioperative hemodynamics and time to postoperative analgesia were considered as secondary outcomes.</p> Results <p>Total morphine consumption within the first 24 postoperative hours was significantly lower for the ESPB group (16.4 ± 2.5&#xa0;mg) compared to the RISS group (18.2 ± 1.8&#xa0;mg), <i>p</i> = 0.011. VAS pain scores at rest were significantly lower in the ESPB group at 12 and 18&#xa0;h (<i>p</i> = 0.002, <i>p</i> = 0.018) respectively. VAS scores with movement were significantly lower for the ESPB group at 8&#xa0;h,12&#xa0;h, and 18&#xa0;h (<i>p</i> = 0.011, <i>p</i> = 0.001, and <i>p</i> = 0.018 respectively). The first time to receive postoperative analgesia was significantly longer in the ESPB group (7.3 ± 2.1&#xa0;h) than in the RISS group (6.0 ± 2.1&#xa0;h), <i>p</i> = 0.048. Both groups were comparable in the number of PCA boluses, the number of patients requiring intraoperative fentanyl increments, or recovery time.</p> Conclusion <p>Ultrasound-guided ESPB provides slightly superior postoperative analgesia compared with RISS block in patients undergoing open radical nephrectomy via subcostal anterior incision for renal malignancies.</p> Trial registration <p>The trial was registered at Clinical Trials.gov. <a href="https://clinicaltrials.gov/study/NCT05822011">https://clinicaltrials.gov/study/NCT05822011</a>, trial ID (NCT05822011, 14 March 2023).</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Ultrasound-guided erector spinae plane block versus rhomboid intercostal sub-serratus plane block for postoperative analgesia in open radical nephrectomy: a randomized clinical study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年10月22日

查看全文
  • Doaa Abd Eltwab,
  • Sayed M. Abed,
  • Ahmad Saad,
  • Maha A. Abdel Aliem,
  • Khaled A. Elsamahy,
  • Fatma H. Elshamy,
  • Ahmed F. Gad,
  • Walaa Y. Elsabeeny

摘要

Background

Open radical nephrectomy often results in significant acute postoperative pain. Regional anesthesia offers an alternative analgesic approach in these situations. This study aims to assess and compare the effectiveness of ultrasound-guided rhomboid intercostal sub-serratus (RISS) block with Erector Spinae Plane Block (ESPB) in patients undergoing open radical nephrectomy.

Methods

This randomized clinical trial included 42 patients scheduled for open radical nephrectomy (RN). Patients were randomly assigned to one of two groups: the ESPB Group (n = 21), which received an ESPB with 30 ml of bupivacaine 0.25%, or the RISS Group (n = 21), which received a RISS block with 30 ml bupivacaine 0.25%. Total morphine consumption was set as the primary outcome while pain scores, perioperative hemodynamics and time to postoperative analgesia were considered as secondary outcomes.

Results

Total morphine consumption within the first 24 postoperative hours was significantly lower for the ESPB group (16.4 ± 2.5 mg) compared to the RISS group (18.2 ± 1.8 mg), p = 0.011. VAS pain scores at rest were significantly lower in the ESPB group at 12 and 18 h (p = 0.002, p = 0.018) respectively. VAS scores with movement were significantly lower for the ESPB group at 8 h,12 h, and 18 h (p = 0.011, p = 0.001, and p = 0.018 respectively). The first time to receive postoperative analgesia was significantly longer in the ESPB group (7.3 ± 2.1 h) than in the RISS group (6.0 ± 2.1 h), p = 0.048. Both groups were comparable in the number of PCA boluses, the number of patients requiring intraoperative fentanyl increments, or recovery time.

Conclusion

Ultrasound-guided ESPB provides slightly superior postoperative analgesia compared with RISS block in patients undergoing open radical nephrectomy via subcostal anterior incision for renal malignancies.

Trial registration

The trial was registered at Clinical Trials.gov. https://clinicaltrials.gov/study/NCT05822011, trial ID (NCT05822011, 14 March 2023).