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Effect of Adding Erector Spinae Plane Block to a Multimodal Analgesic Regimen on Quality of Recovery After
Pei-Shan Chen1, Shao-Hua Liu1, Lu Feng1
1Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.
Background:
Available evidence regarding the effect of erector spinae plane block (ESPB) as a component of multimodal analgesia on postoperative quality of recovery after laparoscopic colon cancer surgery remains inconsistent.
Purpose:
This trial aimed to determine whether adding single-shot bilateral ESPB to a multimodal analgesic regimen would improve early postoperative quality of recovery.
Methods:
In this prospective, randomized, outcome-assessor-blinded controlled trial, 60 participants undergoing laparoscopic radical resection of colon cancer under general anesthesia were randomly assigned (1:1) to receive the ultrasound-guided bilateral single-shot ESPB at the T12 level with 20 mL of 0.25% ropivacaine on each side or a sham procedure before anesthesia induction. The primary outcome was the QoR-15 score at 24 h postoperatively. Secondary outcomes included mean intraoperative remifentanil infusion rate, postoperative sufentanil consumption, postoperative pain scores, time to first patient-controlled intravenous analgesia demand, time to first ambulation, time to first flatus, adverse events, and patient satisfaction.
Results:
Five participants were excluded after randomization; therefore, data from 55 participants were included in the per-protocol analysis. The adjusted mean QoR-15 score at 24 h postoperatively was 126.2 in the ESPB group and 120.3 in the control group, with an adjusted mean difference of 5.88 points (95% confidence interval, 4.02-7.74; p<0.001). Compared with the control group, the ESPB group had a lower intraoperative remifentanil use (p<0.001) and a shorter time to first ambulation (p=0.007). No significant between-group differences were observed in other secondary outcomes.
Conclusion:
Adding single-shot bilateral ESPB to a multimodal analgesic regimen was associated with an improved quality of early postoperative recovery, a lower intraoperative remifentanil use and earlier ambulation in patients undergoing laparoscopic colon cancer surgery. Larger multicenter studies are warranted to confirm these findings.
Trial Registration:
Chinese Clinical Trial Registry, ChiCTR2300073180; date of registration: July 4, 2023.
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