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A Comparative Analysis of Erector Spinae Plane Block Versus Conscious Sedation in Managing Percutaneous Cholecystostomy Pain

  • Clinical Investigation
  • Biliary
  • Published:
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Abstract

Purpose

This study investigates the efficacy of erector spinae plane block (ESPB) for managing perioperative and postoperative pain in patients undergoing percutaneous cholecystostomy (PC) for acute cholecystitis, particularly in high-risk elderly patients with extensive comorbidities and limited functional status.

Methods

In a retrospective single-center study, 58 high-risk patients scheduled for PC were assessed. ESPB was administered to 23 patients, while 22 received conscious sedation. Pain intensity was measured using the numeric rating scale before any analgesic or ESPB administration, during the procedure and at 1 and 12 h post-procedure and secondary outcomes included adverse effects and additional analgesic requirements.

Results

The ESPB group experienced significant pain reduction during and post-procedure compared to the conscious sedation group (p = 0.002). Procedure times were shorter (p = 0.015), and postoperative tramadol was less frequently needed in the ESPB group (p = 0.007). The incidence of nausea was also lower in the ESPB group (p = 0.001). No ESPB-related complications were reported.

Conclusion

ESPB significantly alleviates perioperative and postoperative pain in PC patients, reducing additional analgesic use and side effects. It holds promise as a key component of pain management for high-risk surgical patients.

Level of Evidence

Level 3, Non-randomized controlled cohort/follow-up study.

Graphical Abstract

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Authors and Affiliations

  1. Department of Interventional Radiology, Basaksehir Cam and Sakura City Hospital, 34480, Istanbul, Turkey

    Ilhan Nahit Mutlu, Tevfik Guzelbey, Cagri Erdim, Ali Dablan & Ozgur Kılıckesmez

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  1. Ilhan Nahit Mutlu
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  2. Tevfik Guzelbey
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  3. Cagri Erdim
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  4. Ali Dablan
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  5. Ozgur Kılıckesmez
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Corresponding author

Correspondence to Tevfik Guzelbey.

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Conflict of interest

Ozgur Kılıçkesmez is a paid consultant for Boston Scientific (Marlborough, Massachusetts), Medtronic (Dublin, Ireland). The other authors declare that they have no conflict of interest.

Ethical Approval

We conducted a retrospective, single-center, single-arm and descriptive study, which received approval from our institutional ethics review board. Our protocol number is 2023–03-101.

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Mutlu, I.N., Guzelbey, T., Erdim, C. et al. A Comparative Analysis of Erector Spinae Plane Block Versus Conscious Sedation in Managing Percutaneous Cholecystostomy Pain. Cardiovasc Intervent Radiol (2024). https://doi.org/10.1007/s00270-024-03722-z

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