Original Articles
Evaluation of efficacy of Erector spinae plane block against that of Oblique subcostal Transversus abdominis plane block under ultrasound guidance for post operative analgesia following abdominal surgeries | |
Dr. Malla Alekhya, Dr. Koneti Lohitha, Dr. M Rishika Reddy | |
Background: Acute Post operative pain interfere with the rehabilitation. Management of postoperative pain relieve suffering and leads to earlier mobilization, shortened hospital stay, reduced hospital costs, and increased patient satisfaction. The major goal in the management of postoperative pain is to minimize the dose of medications to lessen side effects & provide adequate analgesia. Effective postoperative pain control is an essential & humanitarian need of every surgical procedure. Inadequate pain control may result in increased mortality. The advantages of effective postoperative pain management include patient comfort and therefore satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, a reduced risk of deep vein thrombosis, faster recovery with less likelihood of the development of neuropathic pain, and reduced cost of care. Pain control methods in the recent advances include Erector Spinae planeblock and Transversus abdominis plane block. Erector spinae plane (ESP) block is an interfascial plane block given at the paraspinal region and provides effective visceral and somatic analgesia.Transversus abdominis plane (TAP) block is also an interfascial block that provides adequate somatic pain control. Advancements in ultrasonography (USG) techniques have improved rehabilitation methodologies. USG has improved the specificity and sensitivity of these pain control methods. Material & methods: This Prospective Randomised comparative study was conducted in the department of Anaesthesiology with the study group of 60 scheduled for Abdominal surgeries divided equally in two groups. Group A received 40ml of 0.25% Bupivacaine in erector spinaeplane block .Patients in Group B received 40ml of 0.25% Bupivacaine in Transversusabdominis plane block under ultrasound guidance following strict asepticprecautions. Results :There was no significant difference in mean distribution of age between the two groups.Group A patients are hemodynamically more stable in terms of SBP, DBP, HR, MAP than Group B patients. Duration of analgesia is more for Group A than Group B with mean duration of analgesia for 641min for Group A & 548min for Group B with p value of<0.001.Minimum VAS score in group A compared to group B. In our study ESPB patients were more comfortable than OSTAPB patients with VAS of 2 till 10hrs. Conclusion : The present study demonstrated the efficacy of ESPB and OSTAPB under ultrasound guidance for postoperative analgesia following abdominal surgeries showedGroup A (ESPB) patients were found to be comfortable both in terms of visual analogue score and hemodynamic stability i.e SBP, DBP, HR,MAP than the Group B (OBSTAP) with mean duration of analgesia for 641min for Group A and 548min for Group Bwith p value of <0.001. It can be concluded that the ESPB is better than OSTAPB in providing more duration of analgesia in abdominal surgeries. |
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