Objective: Pectus excavatum (PE) repair is burdened by severe postoperative pain. This retrospective
study aimed to determine whether the analgesic effect of ultrasound-guided erector
spinae plane block (ESPB) plus standard intravenous analgesia (SIVA) might be superior
to SIVA alone in pain control after PE surgical repair via Ravitch or Nuss technique.
Design: A retrospective cohort study.
Setting: At a university hospital.
Participants: All participants were scheduled for surgical repair of PE.
Interventions: From January 2017 to December 2019, all patients who received ESPB plus SIVA or SIVA
alone were investigated retrospectively. A 2:1 propensity-score matching analysis
considering preoperative variables was used to compare analgesia efficacy in 2 groups.
All patients received a 24-hour continuous infusion of tramadol, 0.1 mg/kg/h, and
ketorolac, 0.05 mg/kg/h, via elastomeric pump, and morphine, 2 mg, intravenously as
a rescue drug. The ESPB group received preoperative bilateral ESPB block. Postoperative
pain, reported using a numerical rating scale at 1, 12, 24, and 48 hours after surgery;
the number of required rescue doses; total postoperative morphine milligram equivalents
consumption; and the incidence of postoperative nausea and vomit were analyzed.
Measurement and Main Results: A total of 105 patients were identified for analysis. Propensity-score matching resulted
in 38 patients in the SIVA group and 19 patients in the ESPB group. Postoperative
pain, the number of rescue doses, and postoperative nausea and vomit incidences were
lower in the ESPB group (p < 0.005).
Conclusions: Erector spinae plane block may be an effective option for pain management after surgical
repair of PE as part of a multimodal approach. This study showed good perioperative
analgesia, opioid sparing, and reduced opioid-related adverse effects.
Key Words
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Article info
Publication history
Published online: August 26, 2022
Footnotes
Domenico Massullo and Mohsen Ibrahim are co-senior authors who equally contributed to the paper.
Identification
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