Akademik Veri Yönetim Sistemi
NIGERIAN JOURNAL OF CLINICAL PRACTICE, cilt.26, sa.2, ss.153-161, 2023 (SCI-Expanded)
Background: Ultrasound-guided bilateral erector spinae plane block is also a
technique for providing analgesia after a cesarean section. Aim: We hypothesized
that bilateral erector spinae plane block applied from the transverse process of T9
who underwent elective cesarean section could provide effective postoperative
analgesia. Patients and Methods: Fifty parturients who were scheduled to
undergo elective cesarean section under spinal anesthesia were included in the
study. Group SA (n = 25) was categorized as the group in which spinal anesthesia
alone (SA) was performed, and Group SA+ESP (n = 25) was categorized as the
group in which SA + ESP block was performed. All patients were given a solution
containing 7 mg isobaric bupivacaine + 15 µg fentanyl intrathecally through
spinal anesthesia. In the SA + ESP group, the bilateral ESPB was performed
at level T9 with 20 ml 0.25% bupivacaine + 2 mg dexamethasone immediately
after the operation. Total fentanyl consumption in 24 h, the visual analogue scale
for pain, and time to the first analgesic request were evaluated postoperatively.
Results: The total fentanyl consumption in 24 h was statistically significantly lower
in the SA + ESP group than the SA group (279 ± 242.99 µg vs. 423.08 ± 212.55
µg, respectively, P = 0.003). The first analgesic requirement time was statistically
significantly shorter in the SA group than the SA + ESP group (150.20 ± 51.83 min
vs. 197.60 ± 84.49 min, respectively, P = 0.022). Postoperative VAS scores at 4th,
8th, and 12th h at rest were statistically significantly lower in group SA + ESP than
in group SA (P = 0.004, P = 0.046, P = 0.044, respectively). VAS scores during
the postoperative 4th, 8th, and 12th h cough were statistically significantly lower in
group SA + ESP than in group SA (P = 0.002, P = 0.008, P = 0.028, respectively).
Conclusion: Ultrasound-guided bilateral ESP provided adequate postoperative
analgesia and significantly decreased postoperative fentanyl consumption in
patients having cesarean section. Also, it has a longer analgesia time than the
control group, and it has been shown to delay the first analgesic requirement.
Keywords: Cesarean section, erector spinae plane block, postoperative pain,
spinal anesthesia