Efficacy of the Erector Spinae Plane Block for Quality of Recovery in Bariatric Surgery: a Randomized Controlled Trial

• Published in: Obesity surgery Vol. 33; no. 9; pp. 2640 - 2651
• Main Authors: Toprak, Hatice, Başaran, Betül, Toprak, Şükrü S., Et, Tayfun, Kumru, Nuh, Korkusuz, Muhammet, Bilge, Ayşegül, Yarımoğlu, Rafet
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.09.2023; Springer Nature B.V
• Subjects: Analgesics; Anesthesia; Anesthesiology; Clinical trials; Drug dosages; Drug overdose; Gastrointestinal surgery; Hospitals; Laparoscopy; Medicine; Medicine & Public Health; Narcotics; Obesity; Original Contributions; Pain management; Patients; Questionnaires; Sleep apnea; Surgery; Ultrasonic imaging; Weight control; Postoperative recovery quality; Analgesia consumption; Erector spinae plane block (ESPB); Bariatric surgery
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-023-06748-3

Background Postoperative pain management after bariatric surgery is difficult due to different physiological properties and high sensitivity toward opioids in patients with obesity. It has been reported that erector spinae plane block (ESPB) contributes to postoperative analgesia when applied together with multimodal analgesia. Methods Eighty patients were randomized either bilateral ESPB (group E) each side or no block (group C). Our primary aim was to evaluate the effects of ESPB on the quality of recovery 24 h postoperatively in bariatric surgery by using 40-item Quality of Recovery-40 (QoR-40) questionnaire. Postoperative pain assessed using a numerical rating scale (NRS), time of additional analgesic requirement, analgesic consumption, side effects, sedation, mobilization time, and postoperative complications were evaluated as secondary outcomes. Results Postoperative mean QoR-40 scores were found to be higher in group E (175.02 ± 11.25) than in group C (167.78 ± 18.59) at the postoperative 24th hour ( P  < 0.05). Pain scores at rest and during movement were higher in group C than in group E. At the postoperative 24th hour, NRS mean SD scores at rest for group C and group E were 3.25 ± 1.32 and 2.40 ± 0.96, respectively. NRS mean SD scores during movement for groups C and E were 3.88 ± 1.49 and 3.12 ± 1.30, respectively. The total amount of tramadol consumed in the first 24 h in group C and group E were mean SD: 86.40 ± 69.60 and 40.00 ± 46.96, respectively; P  < 0.05. Conclusions ESPB improved postoperative quality of recovery, reduced NRS scores, and total analgesic consumption in patients with obesity undergoing bariatric surgery. Clinical Trial Registration NCT05020379. Graphical Abstract