Effectiveness of the bilateral and bilevel erector spinae plane block (espb) in pediatric idiopathic scoliosis surgery: a randomized, double-blinded, controlled trial

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dc.authorid0000-0002-3245-6614
dc.contributor.authorDomagalska, Ma?gorzata
dc.contributor.authorÇiftçi, Bahadır
dc.contributor.authorJanusz, Piotr
dc.contributor.authorReysner, Tomasz
dc.contributor.authorDaroszewski, Przemys?aw
dc.contributor.authorKowalski, Grzegorz
dc.contributor.authorWieczorowska-Tobis, Katarzyna
dc.contributor.authorKotwicki, Tomasz
dc.date.accessioned2024-05-28T10:58:45Z
dc.date.available2024-05-28T10:58:45Z
dc.date.issued2024
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Anesteziyoloji ve Reanimasyon Ana Bilim Dalı
dc.description.abstractBackground: This study aimed to compare the effect of the ultrasound-guided bilateral and bilevel erector spinae plane block (ESPB) on pain scores, opioid requirement, intraoperative motor-evoked potentials (MEPs), and stress response to surgery expressed by the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) versus standard analgesia methods following idiopathic scoliosis surgery. Methods: This was a prospective, double-blinded, randomized controlled trial. Sixty patients aged 10 to 18 years and physical status ASA 1 or 2 were randomized into 2 equal groups, each receiving an ESPB or sham block. The primary outcome was the pain scores (Numerical Rating Scale, NRS) within 48 hours after spinal correction and fusion surgery for idiopathic thoracic scoliosis. The secondary outcomes were total opioid consumption, NLR, and PLR levels at 12 and 24 hours postoperatively and intraoperative MEPs. Results: ESPB patients presented lower NRS scores, signifying less pain, at all time points (30, 60, 90, 120 min; and 6, 12, 24, and 48 h after surgery), all P<0.0001. The total opioid consumption, the incidence of nausea or vomiting, and the need for remifentanil and propofol during surgery were significantly lower in the ESPB group. The surgery-induced stress response expressed by NLR and PLR was considerably lower in the ESPB group. ESPB did not affect the intraoperative MEP's amplitude. Conclusions: ESPB is effective for postoperative analgesia, can reduce opioid consumption in patients undergoing scoliosis surgery, and reduces the stress response to surgery. ESPB does not interfere with neuromonitoring. Level of evidence: Level I.
dc.identifier.citationDomagalska, M., Çiftçi, B., Janusz, P., Reysner, T., Daroszewski, P., Kowalski, G. ... Kotwicki, T. (2024). Effectiveness of the bilateral and bilevel erector spinae plane block (espb) in pediatric idiopathic scoliosis surgery: a randomized, double-blinded, controlled trial. Journal of Pediatric Orthopedics, 44(7), e634-e640. http://dx.doi.org/10.1097/BPO.0000000000002707
dc.identifier.doi10.1097/BPO.0000000000002707
dc.identifier.endpagee640
dc.identifier.issn0271-6798
dc.identifier.issn1539-2570
dc.identifier.issue7
dc.identifier.pmid38689466
dc.identifier.scopus2-s2.0-85198353374
dc.identifier.scopusqualityQ2
dc.identifier.startpagee634
dc.identifier.urihttp://dx.doi.org/10.1097/BPO.0000000000002707
dc.identifier.urihttps://hdl.handle.net/20.500.12511/12520
dc.identifier.volume44
dc.identifier.wos001270810600002en_US
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorÇiftçi, Bahadır
dc.institutionauthorDaroszewski, Przemys?aw
dc.language.isoen
dc.relation.ispartofJournal of Pediatric Orthopedicsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/embargoedAccess
dc.subjectErector Spinae Plane Block
dc.subjectESPB
dc.subjectNeutrophil-To-Lymphocyte Ratio
dc.subjectNLR
dc.subjectPlatelet-To-Lymphocyte Ratio
dc.subjectPLR
dc.titleEffectiveness of the bilateral and bilevel erector spinae plane block (espb) in pediatric idiopathic scoliosis surgery: a randomized, double-blinded, controlled trial
dc.typeArticle

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