Downloads
Abstract
Background: Pain after hip replacement surgery is usually moderate or severe. There are many methods for pain relief after hip replacement surgery. However, the currently-applied post-operative pain management methods have some side effects and complications. Lumbar erector spinae plane block is a safe and effective technique for hip arthroplasty. Objectives: To observe the effectiveness of lumbar erector spinae plane block (LESP) in pain relief after hip arthroplasty and the adverse effects of the procedure. Methods: A descriptive study was carried out on 6 patients who were indicated for hip arthroplasty. After the surgery, the patients had a catheter placed in the plane of the erector spinae muscle at the lumbar level (LESP L3) in the operating room. In the recovery room, when VAS ≥ 4, the patients were administered Anaropin 0.5% via ESP L3 catheter, and a continuous analgesia regimen following standard protocol was set up. The patients were monitored and their pain score was assessed after 24 hours, and 48 hours at the study times; (maximum VAS scores at rest and during mobility). Results: The maximum VAS score at rest was 0.5 and that during mobility was 2.5 on the first day. These scores were 0.3 at rest and 2.3 during mobility on the second day. The proportion of patients who were strongly satisfied and satisfied was 100%. No adverse effects were recorded in this study. Conclusions: The lumbar erector spinae plane block can be applied to relieve postoperative pain in hip arthroplasty.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2023 Journal of Science and Technology in Medicine and Pharmacy
Ali Ahiskalioglu, et al. Lumbar Erector Spinae Plane Block as a Main Anesthetic Method for Hip Surgery in High Risk Elderly Patients: Initial Experience with a Magnetic Resonance Imaging. Eurasian J Med. 52(1), 16-20 (2020).
Byung-Woo Min, MD, et al. Perioperative Pain Management in Total Hip Arthroplasty: Korean Hip Society Guidelines. Hip & Pelvis. 28(1), 15-23 (2016).
Choi P BM, Scott J, Douketis JD. Epidural analgesia for pain relief following hip or knee replacement. Cochrane Database of Systematic Reviews. Issue 3 (2003).
Duarte LT BP SR. Effects of epidural analgesia and continuous lumbar plexus block on functional rehabilitation after total hip arthroplasty. Rev Bras Anestesiol, 59, 531 – 534 (2009).
Dahlia Townsend, et al. Lumbar Erector Spinae Plane Block for Total Hip Arthroplasty Comparing 24-Hour Opioid Requirements: A Randomized Controlled Study. Anesthesiology Research and Practice, Article ID 9826638, 8 pages (2022).
FJ Singelyn TF MM, D Joris. Effects of intravenous patient-controlled analgesia with morphine, continuous epidulal analgesia and continuous femoral nerve sheath block on rehabilitation after unilatelal total hip arthroplasty. Reg Anesth Pain Med. 30, 452-457 (2005).
M. Anger, T. Valovska. PROSPECT guideline for total hip arthroplasty: a systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia. 76, 1082–1097 (2021).
Singh S., Ranjan R., Lalin D. A new indication of erector spinae plane block for perioperative analgesia is total hip replacement surgery-a case report. Indian Journal of Anaesthesia. 63(4), 310 (2019).
Sakura Kinjo, et al. Continuous lumbar erector spinae plane block for postoperative pain management in revision hip surgery: a case report. Brazilian Journal of Anesthesiology; 69, Issue 4, p. 420-422 (2019).
Tulgar S., Senturk O. Ultrasound guided erector spinae plane block at L-4 transverse process level provides effective postoperative analgesia for total hip arthroplasty. Journal of Clinical Anesthesia. 44, 68 (2018).