TY  - BOOK
AU  - Hala Ahmed Elsabbagh
AU  - Amr Kamal Abdelmohsen , 
AU  - Hebatallah Salah Abdelhamid , 
AU  - Shereen Mostafa Amin , 
TI  - Randomized comparative trial of pre-surgical lumbar epidural analgesia with bilateral erector spinae block for perioperative pain management in lumbar spine surger / 
PY  - 2021///
CY  - Cairo : 
PB  - Hala Ahmed Elsabbagh , 
KW  - Erector Spinae plane Block
KW  - Pain
KW  - Spine Surgery
N1  - Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Anaesthesia; Issued also as CD
N2  - Background: Spine surgery is one of the most painful surgical procedures, with median pain scores (using the 0-10 NRS-numeric rating scale) on the first postoperative day ranging from 5 (spinal decompression) to 7 (spinal fusion).The epidural analgesia is a well-established and highly effective block where the local anaesthetics (LA) spread from the epidural space to the spinal cord, nerve roots, and cerebrospinal fluid. However, the Erector Spinae plane block (ESPB) proved to be efficient in controlling post-operative pain in a variety of surgeries including the spine surgery. Our aim was to compare the first demand to rescue analgesia postoperatively in epidural and ESPB groups. Secondary outcomes were to compare NRS pain score, postoperative morphine consumption, changes in arterial blood pressure (ABP), heart rate (HR) and adverse events. Patients and Methods: Sixty patients scheduled for elective lumbosacral spine decompression and fixation surgery were enrolled in the study. Patients were allocated into 2 groups, 30 patients each. In the epidural Group, patients underwent ultrasound-guided single-shot epidural injection, while in the ESPB group, patients were handled with ultrasound-guided single-shot ESPB.Results: time to first demand of rescue analgesia in the ESPB group (11.5 hours) was longer than that in the epidural group (7 hours). Moreover, the ESPB group decreased the 24hour consumption of morphine (3.5mg) when compared with the epidural group (7.5mg).The NRS pain score decreased post-operatively in both groups when compared to the baseline throughout all assessment points. Between both groups, the NRS was lower in the epidural group immediately postoperative and at 1, 2 and 8 hours. However, at 4, 12 and 24 hours, both groups were comparable.The study also showed that the number of patient who experienced hypotension and tachycardia intra-operatively was more in the epidural group than the ESPB group
ER  -