Erector spinae plane block for radiofrequency ablation of hepatic focal lesions: Randomized controlled trial

Mona Raafat Elghamry; Mohamed Ahmed Lotfy; Kareem Mohammed Ramadan; Mohammad Ali Abduallah

doi:10.5055/jom.0838

Authors

Mona Raafat Elghamry, MD https://orcid.org/0000-0002-7087-864X
Mohamed Ahmed Lotfy, MD https://orcid.org/0000-0002-1011-9465
Kareem Mohammed Ramadan, MD https://orcid.org/0000-0002-9301-9477
Mohammad Ali Abduallah, MD https://orcid.org/0000-0002-7087-864X

DOI:

https://doi.org/10.5055/jom.0838

Keywords:

conscious sedation, erector spinae plane block, fentanyl, liver neoplasms, radiofrequency ablation

Abstract

Objective: This study evaluated the opioid sparing and pain relief effect of erector spinae plane block (ESPB) for radiofrequency ablation (RFA) of hepatic focal lesions under conscious sedation.

Design: A randomized controlled trial.

Setting: Tanta University Hospitals.

Patients: Fifty patients aged 30-60 years old and eligible for RFA of hepatic focal lesions were included.

Interventions: Patients randomized to receive either local anesthetic infiltration (group I) or ESPB (group II). Both groups received sedation by propofol infusion.

Main outcome measure(s): The primary outcome was total fentanyl consumption. Secondary outcomes were nonverbal pain score (NVPS), time to first analgesic request post-procedure, radiologist's satisfaction, and complications.

Results: In group I, NVPS was significantly increased at 10, 15, 25, and 30 minutes during RFA compared to group II (p = 0.008, <0.001, 0.018, and 0.001, respectively) with no significant differences on arrival to post-anesthesia care unit (PACU) and after 1 hour. Total fentanyl consumption during the procedure was significantly increased in group I compared to group II (160.9 ± 38.2 and 76 ± 21 μg, respectively; p < 0.001) with prolonged time to first analgesia request post-procedure in group II compared to group I (392.7 ± 38.8 and 101.1 ± 13.6 minutes, respectively; p < 0.001). The level of radiologist's satisfaction was significantly increased in the group II (p = 0.010). Three patients in group I and one patient in group II needed general anesthesia. Lower incidence of complications in group II occurred with statistical insignificance.

Conclusions: The ESPB provided adequate analgesia and reduced opioids consumption during the hepatic RFA, with high radiologist's satisfaction.

Author Biographies

Mona Raafat Elghamry, MD

Lecturer of Anesthesia, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt

Mohamed Ahmed Lotfy, MD

Lecturer of Anesthesia, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt

Kareem Mohammed Ramadan, MD

Lecturer of Radiodiagnosis, Radiodiagnosis Department, Faculty of Medicine, Tanta University, Tanta, Egypt

Mohammad Ali Abduallah, MD

Assistant Professor of Anesthesia, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt

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