Effect of Sacral Erector Spinae Plane Block on Postoperative Analgesia in Perianal Surgeries: A Randomised Controlled Trial
Sanjaya Kumar Behera, Sunil Kumar Pattnaik, Mousumi Das, Partha Sarathi Mohapatra, Krishna Mishra, Lingaraj Sahu
1. Associate Professor, Department of Anaesthesiology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
2. Associate Professor, Department of General Surgery, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
3. Associate Professor, Department of Anaesthesiology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
4. Associate Professor, Department of Anaesthesiology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
5. Assistant Professor, Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
6. Professor, Department of Anaesthesiology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Correspondence Address :
Dr. Partha Sarathi Mohapatra,
Department of Anaesthesiology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha-751024, India.
E-mail: rikunmohapatra123@gmail.com
Abstract
Introduction: Sacral nerves emerge through sacral foramina and traverse below the multifidus muscle. Hence, blocking this myofascial plane can provide postoperative analgesia in the perianal region by blocking the sacral nerves supplying it.
Aim: To study the effect of Sacral Erector Spinae Plane Block (SESPB) on postoperative pain and postoperative analgesic requirement in perianal surgeries.
Materials and Methods: A randomised controlled trial was done with 60 patients who were randomly allocated into two groups (30 in each group). Group 1 patients received no intervention, whereas Group 2 received bilateral SESPB. The Visual Analogue Scale (VAS), opioid requirement, first analgesic demand, and additional analgesic requirement were compared between the two groups. The qualitative data was analysed by Student’s t-test, whereas the quantitative data was analysed using the Chi-square test. A p-value of <0.05 was considered statistically significant.
Results: Around 18 (60%) of the participants in group 1 were males, whereas group 2 consisted of 15 (50%) males. The mean age in group 1 was 40.7±11.5 years, whereas it was 43.6±12.7 years in group 2. The means of BMI were similar in both groups. The mean VAS score of group 1 was 3.19±0.23, whereas it was 2.37±0.25 in group 2. The first analgesic requirement was significantly delayed, and total tramadol requirement was lower in group 2 compared to group 1. Four patients from group 1 (control group) required inj. diclofenac sodium additionally.
Conclusion: Bilateral SESPB provided good postoperative analgesia in patients who underwent perianal surgery. The total analgesic requirement was also found to be lower with this block. Hence, it can be considered a modality for perianal surgeries.
Keywords
Nerve block, Pain management, Regional analgesia, Ultrasound-guided
DOI and Others
DOI: 10.7860/JCDR/2024/67737.19247
Date of Submission: Sep 28, 2023
Date of Peer Review: Dec 18, 2023
Date of Acceptance: Jan 30, 2024
Date of Publishing: Apr 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Sep 29, 2023
• Manual Googling: Dec 16, 2023
• iThenticate Software: Jan 27, 2024 (9%)
ETYMOLOGY: Author Origin
EMENDATIONS: 7