Effect of Bilateral Erector Spinae Plan Block in Colorectal Surgery
Condition: Pain, Postoperative
MeSH terms: Pain, Postoperative
Study type: Interventional

Summary: 
      In this study, it was aimed to evaluate the effects erector spina plane block (ESPB) on
      postoperative opioid consumption in the first 24 hours and pain scores after colorectal
      surgery.
    

Detailed description: 
      Colorectal surgery can be applied for many reasons, among these reasons, colorectal cancer
      (CRC) takes the first place. With the understanding of the pathophysiological effects of
      analgesics better, the use of regional techniques in providing analgesia for patients
      undergoing colorectal cancer surgery has come to the fore. Depending on the surgical
      procedure, pain faced by patients is an important problem that must be deal with in the
      postoperative period.

      In this study, the hypothesis was determined as "Pre-operatively, erector spina plane block
      (ESPB) performed as part of multimodal analgesia reduces postoperative morphine consumption
      and pain scores."

      The patients were divided into two groups :

      Group ESP (erector spinae plan):

      In this group, patients will be administered bilateral ESPB (total of 40 ml, %0.25
      bupivacaine) in addition to IV morphine patient-controlled analgesia (PCA) for the first 24
      postoperative hours.

      Group GA (general anesthesia):

      In this group, patients will be administered only IV morphine patient-controlled analgesia
      (PCA) for the first 24 postoperative hours.
    

Intervention name(s): Erector spina plane block + general anesthesia; Only general anesthesia
Intervention type(s): Procedure; Procedure
Intervention description(s): Bilateral-injection ultrasound-guided bilateral erector spinae plane block
Pre-operatively, with the patient in the sitting position, 20ml 0.25% bupivacaine will be administered between the T9 spinous process and the erector spinae muscles with the guidance of an ultrasound probe placed on a parasagittal plane. The same procedure was applied bilaterally.
Intraoperative analgesia: After anesthesia induction tenoxicam 20 mg IV and 30 min. before the end of the surgery paracetamol (1gr) iv was applied.
Postoperative analgesia: IV-PCA: The requested dose will be 20µg/kg morphine, the lock-in time will be 6-10 minutes, the 4-hour limit will be 80% of the total calculated dose.
Rescue analgesia was provided with iv tramadol 30 mg boluses whenever the Visual analog scale pain score >3, (max doses 300 mg/day).; Intraoperative analgesia: After anesthesia induction tenoxicam 20 mg IV and 30 min. before the end of the surgery paracetamol (1gr) iv was applied.
Postoperative analgesia: IV-PCA: The requested dose will be 20µg/kg morphine, the lock-in time will be 6-10 minutes, the 4-hour limit will be 80% of the total calculated dose.
Rescue analgesia was provided with iv tramadol 30 mg boluses whenever the Visual analog scale pain score >3, (max doses 300 mg/day).
Other intervention name(s): Group ESP; Group GA
Intervention MeSH terms: Anesthetics
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Our study is a single center, prospective, randomized controlled, single-blinded, parallel group.
Masking: Triple (Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Regional anesthesia; Erector spinae plane block; Post-operative analgesia; Laparoscopy; Open surgery; Colorectal surgery