ESP block advantages include its simplicity, easy identifiable ultrasonographic landmarks and
low risk for serious complications as injection is into tissue plane that is distant from
pleura, major blood vessels and discrete nerves. Coupled with the fact that the erector
spinae muscle and ESP extend down to the lumbar spine, ESP block was hypothesized to be
performed at the level of L4. In a recent case report, ultrasound guided ESP block was
successfully performed at L4 transverse process level for postoperative analgesia after total
hip arthroplasty. However, confirmation of the efficacy of ESP block in hip replacement
surgeries needed more investigation.
Postoperative Pain
Clinical Trial – The Analgesic Efficacy of Bilateral Erector Spinae Plane Block in Comparison With Intrathecal Morphine After Elective Cesarean Section
The aim of this study was to assess the analgesic efficacy of bilateral erector spinae plane
block in comparison with intrathecal morphine after elective cesarean section under spinal
anesthesia.
Clinical Trial – Spinal Hydromorphone Versus Morphine for Post-Cesarean Delivery Analgesia
Morphine is usually used for pain relief after cesarean delivery. However, sometimes it is
not available, the patient might be allergic to morphine or intolerant to its side effects.
Hydromorphone, another drug from the same class, might be used alternatively, but we need to
prove that it is not inferior to morphine.
Clinical Trial – Comparative Study of the Analgesic Effect of Spinal Anesthesia or Infiltration Anesthesia for Hemorrhoidectomy
Background and Objectives: Postoperative analgesia and early recovery are relevant for
hospital discharge after hemorrhoidectomy. This study investigated the postoperative
analgesic effect with local infiltration compared with spinal block.
Methods: This randomized study included 40 patients aged 18 to 60 years old. Local group (LG)
received local infiltration under general anaesthesia; spinal group (SG) received a
subarachnoid block. LG received general anaesthesia with propofol, atracurium and propofol
infusion as well as a local infiltration of 20 ml 0.75% ropivacaine. SG received 2 ml of 0.5%
hyperbaric bupivacaine. Analgesic supplementation was with 50µg of fentanyl for LG and 1%
lidocaine for SG. There were assessed: postoperative pain intensity, sphincter relaxation,
motor blockade of lower limbs, time to discharge, analgesic dose over 1 week and adverse
effects.
Clinical Trial – intrathecaم Ketamine, Morphine and Both for Lower Abdominal Cancer Surgery Pain
this study investigates the analgesic efficacy and other possible effects of ketamine,
morphine, and both together when administered intrathecally for control of postoperative pain
following lower abdominal cancer surgeries.
Clinical Trial – The Effect of Adding Nalbuphine to Intrathecal Morphine on Analgesic Efficacy and Side Effects After Cesarean Section
The primary endpoint of this study is to investigate the effect of adding nalbuphine to
intrathecal morphine on quality of postoperative analgesia and Morphine related side effects
post- cesarean delivery.
Clinical Trial – Combined Intrathecal Morphine and Dexmedetomidine Analgesia
The current study investigated the effect of adding dexmedetomidine to intrathecal morphine
for postoperative analgesia in cancer patients undergoing major abdominal surgery.
Clinical Trial – Continuous Pre-uterine Wound Infiltration Versus Intrathecal Morphine for Postoperative Analgesia After Cesarean Section
The cesarean section is considered as a painful surgery during the post operative period.
Mothers may need to move immediately after the surgery to take care of their babies. This may
increase the risk of major pain and chronic pain. Thus, excellent postoperative analgesia is
required so that mothers do not experience pain in caring for their baby. Currently, several
techniques have been developed to manage postoperative pain related to c-section scar such as
intrathecal morphine during spinal anesthesia or continuous pre-peritoneal wound
infiltration. The comparison between anesthetic techniques has never been performed and it is
still not know if the combination of intrathecal morphine plus continuous pre-peritoneal
wound infiltration provide a synergistic or additional effect on pain relief.