Postoperative Pain Clinical Trial
Official title:
Erector Spinae Plane Block Versus Traditional Pain Management for Enhanced Recovery After Surgery
Patients undergoing thoracotomy, thoracoscopy or other surgical procedures involving the
integrity of the chest wall are always in a special point of interest of both surgical and
anesthesiological specialities. Most of the patients will describe the pain after thoracic
surgery as severe. It might lead to a number of serious complications: respiratory failure
due to splinting; inability to clear secretions by effective coughing, with resulting
pneumonia; and turning into a chronic pain: the post-thoracotomy pain syndrome.
Traditional pain management in these groups of patients — such as opiate treatment, thoracic
epidural analgesia, and non-opioid drugs — may have serious side effects. Large doses of
opiates suppress the cough reflex and lead to respiratory depression with subsequent
re-intubation and re-ventilation. Thoracic epidural analgesia, though being considered
paramount among other analgesic options, requires a significant clinical experience. Still,
it might be insufficient for satisfactory pain control and even complicated with
pneumothorax, total spinal anaesthesia and inadvertent intravascular injection. Non-steroidal
anti-inflammatory drugs (NSAIDs) and Tramadol are weak analgesics inadequate for severe pain
control and might be responsible for gastrointestinal bleeding.
We suggest performing erector spinae plane block for intraoperative and postoperative pain
management due to the ease of use and better analgesic effect. What remains is hard proof for
the clinical efficacy and safety of this block, followed by a demonstration of the uptake of
it in the hands of non-regional anaesthetists.
n/a
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