Clinical efficacy of ultrasound guided erector spinae plane block in patients undergoing microwave ablation

Özlem Öz Gergin; Sibel Seçkin Pehlivan; İbrahim Erkan; Adnan Bayram; Recep Aksu; Cihangir Biçer; Karamehmet Yıldız; Güven Kahriman

doi:10.15537/smj.2022.43.9.20220245

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Table 1

- Comparison of descriptive characteristics by groups.

Variables	Group control (n=15)	Group ESPB (n=15)	P-value
Age (years)
Mean±sd	64.2±12.6	63.8±8.7	0.934
Min-max	34-77	47-76	0.934
Gender, n (%)
Female	6 (40.0)	8 (53.3)	0.715
Male	9 (60.0)	7 (46.7)	0.715
ASA, n
Grade I	3	2	0.999
Grade II	12	13	0.999
Localization, n (%)			0.143
Subcapsular	10 (66.7)	5 (33.3)	0.143
Intraparenchymal	5 (33.3)	10 (66.7)	0.143
Lesion size
Mean±sd	4.1±2.5	2.7±1.1	0.058
Min-max	(1.80-12.00)	(1.20-5.50)	0.058
Duration of procedure
Mean±sd	9.8±4.24	11.6±3.61	0.267
Min-max	4.0-15.0	5.0-15.0	0.267

Values are presented as number and percentage (%). ESPB: erector spinae plane block, ASA: American Society of Anesthesiology, Sd: standard deviation

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Table 2

- Comparison of heart rate, systolic arterial blood pressure, diastolic arterial blood pressure, and oxygen saturation values by groups (N=25).

Parameters	Groups		Test statistics†
Parameters	Group control (mean±sd)	Group ESPB (mean±sd)	F	P-value
Heart rate
0th min of the intervention	81.93±2.67^a	79.33±2.67	0.473	0.497
5th min of the intervention	95.00±1.51^b	74.07±1.51	96.568	<0.001
10th min of the intervention	81.88±2.80^a	79.52±2.46	0.402	0.533
15th min of the intervention	74.73±3.76^a	77.18±3.18	0.247	0.628
Test statistics‡	F=31.816; p<0.001	F=1.981; p=0.147
Systolic arterial blood pressure
0th min of the intervention	131.67±6.21^a	152.73±6.21^a	5.754	0.023
5th min of the intervention	150.53±2.63^b	128.47±2.63^b	35.267	<0.001
10th min of the intervention	144.26±7.77^ab	153.99±6.99^a	0.866	0.361
15th min of the intervention	151.54±8.28^ab	149.32±7.40^a	0.040	0.843
Test statistics‡	F=4.067; p=0.023	F=10.554; p<0.001
Diastolic arterial blood pressure
0th min of the intervention	79.73±3.34^a	83.13±3.34^a	0.519	0.477
5th min of the intervention	95.33±1.91^b	75.40±1.91^b	54.575	<0.001
10th min of the intervention	88.83±3.51^ab	88.09±3.22^ab	0.024	0.878
15th min of the intervention	90.14±4.78^ab	78.85±4.23^ab	3.127	0.092
Test statistics‡	F=12.444; p<0.001	F=17.685; p<0.001
Oxygen saturation
0th min of the intervention	97.13±0.49^a	96.20±0.49^a	1.791	0.192
5th min of the intervention	97.27±0.38^a	97.67±0.38^ab	0.558	0.461
10th min of the intervention	97.54±0.38^a	97.88±0.33^b	0.475	0.497
15th min of the intervention	97.87±0.38^b	97.77±0.34^b	0.041	0.840
Test statistics‡	F=7.028; p=0.002	F=3.202; p=0.048

*Linear mixed models, †Intergroup comparisons on each measure, ‡Comparisons between measurements in each group a and b superscripts indicate within-group measurement differences. Measurements with the same letters were statistically similar. F: Fisher exact test, min: minutes

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Table 3

- Analgesic consumption during and after the procedure.

Variables	Group control (n=15)	Group ESPB (n=15)	P-value
Total opioid consumption (fentanyl in mcg), M (IQR)	100.0 (50.0)	25.0 (25.0)	<0.001^†
Total opioid amount (fentanyl in mcg/kg/min), M (IQR)	0.1 (0.06)	0.0 (0.0)	<0.001^†
Additional fentanyl consumption throughout the procedure, n (%)
Not performed	0 (0.0)	10 (66.7)	<0.001^‡
Performed	15 (100.0)	5 (33.3)	<0.001^‡
Total Propofol amount (Propofol in mg), M (IQR)	35.0 (10.0)	40.0 (15.0)	0.325^†
Analgesic consumption after the procedure, n (%)
Yes	11 (7.3)	5 (33.3)	0.066^‡
No	4 (26.7)	10 (66.7)	0.066^‡
Time of first analgesic use after the procedure (hours), M (IQR)	2.0 (3.0)	4.3 (12.8)	0.851^†

Values are presented as number and percentages (%). M: median, IQR: interquartile range, †Mann-Whitney U test, ‡Fisher exact test, ESPB: erector spinae plane block

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Table 4

- Distribution of NRS scores by groups.*

NRS score (time)	Group control	Group ESPB	P-value^†
NRS score (time)	mean±sd	mean±sd	P-value^†
Pre-procedure	0.60±1.30	0.67±1.23	0.886
Post-procedure 0th min	1.20±1.08	1.00±1.13	0.625
20th minute	2.27±1.39	1.60±1.24	0.176
40th minute	2.73±1.03	1.60±1.18	0.009
60th minute	3.00±1.36	1.40±0.99	0.001
2nd hour	3.20±1.70	2.00±0.85	0.021
4th hour	2.87±0.74	1.87±0.74	0.001
6th hour	2.60±0.99	2.20±1.01	0.283
12th hour	1.93±1.03	1.93±0.88	>0.999
24th hour	1.20±0.56	1.80±0.86	0.032

Sd: standard deviation, NRS : Numerical Pain Scale, *: Two-way repeated measures analysis of variance, †: p-values with Bonferroni correction

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Table 5

- Comparison of post-procedure complication rates and radiology doctor satisfaction levels between groups (N=15).

Variables	Group control	Group ESPB	P-value
Postoperative complications, n (%)
Yes	1 (6.7)	0 (0.0)	0.999
No	14 (93.3)	15 (100.0)	0.999
Radiology doctor satisfaction score
Not satisfied at all	1 (6.7)^a	0 (0.0)^a	<0.001
Not satisfied	7 (46.7)^a	0 (0.0)b
Reasonable	6 (40.0)^a	2 (13.3)^a
Satisfied	1 (6.7)^a	4 (26.7)^a
Excellent	0 (0.0)^a	9 (60.0)^b

Superscripts a and b indicate the difference between groups in each category. Groups with the same letters in each category were statistically similar. ESPB: erector spinae plane block