ESRA19-0245 Vastus medialis nerve block using neurostimulation associated to ipack and adductor canal block for postoperative analgesia in anterior cruciate ligament reconstruction: a pilot study

Abstract

ESRA19-0263 Figure 1 Abstracts RAPM 2019;44(Suppl 1):A1–A276 A225 admission. The patient experienced no nausea or vomiting, was mobilized easily 6 hours after the block and was discharged 36 hours later. Conclusions The ESP block applied to abdominal laparoscopic surgery has a relatively limited literature, particularly in laparoscopic hysterectomy. This is the reason we believe every new case is a valuable contribution. In this case report, the use of ESPB performed preoperatively dramatically reduced the amount of IV pain medication. The overall result was increased satisfaction of the patient, avoidance of opioid use and fast recovery. ESRA19-0253 DEEP VERSUS SUPERFICIAL ERECTOR SPINAE BLOCK: A PILOT STUDY TO COMPARE THE EFFICACY OF TWO TECHNIQUES C Sinha*, A Kumar, A Kumar, P Kumari. AIIMS, Anaesthesia, Patna, India; AIIMSPatna, Anaesthesia, Patna, India 10.1136/rapm-2019-ESRAABS2019.398 Background and aims Erector spinae plane (ESP) block is a myo-fascial plane block employed as an analgesic technique to provide sensory block at multi-dermatomal levels across the chest wall. It was first used by Forero et al, who had described the two techniques (superficial and deep) with different levels of sensory blockade. The aim of this study was to compare the analgesic requirement and sensory blockade after injecting drug superficial or deep to erector spinae muscle in patients undergoing modified radical mastectomies (MRM). Methods 40 ASA I/II female patients scheduled for unilateral MRM were enrolled in this prospective randomized double blind study. Group 1 received 25 ml 0.2% ropivacaine deep to ES at the T4 level. Group 2 received 25 ml 0.2% ropivacaine superficial to ES at the T4 level. The various parameters studied included: level of sensory blockade assessed preoperatively, duration of analgesia and requirement of opioids postoperatively in 24 hours. Results The mean duration of analgesia was significantly higher in group 1 (6.75 + 0.79 hours vs 5.54 +1.03 hours) (p value = 0.00). The requirement of opioids was significantly less in-group 1 (4.30 +0.87 hours vs 6.10 +1.15 hours) (p value=0.00). There was no statistically significant difference in the dermatomal blockade in either group. Conclusions ESP block (deep to the muscle technique) is a better technique in terms of duration of analgesia and requirement of opioids in the postoperative period for patients undergoing MRM. Further randomized controlled trials are required to substantiate these results. ESRA19-0068 FEMORAL OR ADDUCTOR NERVE CATHETER WITH SCIATIC SINGLE INJECTION FOR TOTAL KNEE ARTHROPLASTY – AN OPTIMAL METHOD FOR REDUCED POSTOPERATIVE PAIN AND FUNCTIONAL DISABILITY I Skok*, J Vukadinovic. University Clinical Center Maribor, Anesthesiology, Slovenia 10.1136/rapm-2019-ESRAABS2019.399 Background and aims This prospective study of long-term outcomes regarding postoperative pain and early mobilization refers to patients undergoing total knee arthroplasty (TKA). We compared an intravenous postoperative analgesia, with peripheral nerve blockade. The aim of our study is to find the optimal analgesic method for such patients in our hospital conditions. Methods 150 patients ASA II after TKA were followed. Ethical committee approval was obtained. Patients were previously randomized and divided into three groups: group A(n=54) received preoperative blockade (ultrasound-guided) of sciatic nerve and adductor canal catheter, group B (n=42) received only spinal anesthesia, followed by intravenous postoperative analgesia at the ward, group C (n=54) received preoperative blockade of sciatic nerve and femoral nerve catheter. All patients received spinal anesthesia for surgery. Intraoperative and postoperative pain was measured in the first 24 hours using visual analogue scale (VAS), as well as use of intravenous analgetics, postoperative nausea, muscle weakness, foot flexion and patient satisfaction score. Results Intraoperative VAS was similar in all groups. Postoperative VAS was lower in groups A and C compared to group B. There is a statistical difference between groups A and C in quadriceps muscle weakness. Foot flexion was slightly longer in group C. Postoperative nausea was found in group B. Patient satisfaction scores were similar in all groups. Conclusions Patients undergoing TKA suffer from long-standing pain and impaired physical functioning. They have a high risk for chronic pain. Pain treatment should start preoperatively by peripheral nerve blockade and continuously through the nerve catheter. Those patients had lower pain scores and better functional recovery. ESRA19-0451 REGIONAL ANAESTHESIA FOR ARTERIO-VENOUS FISTULA IN END STAGE RENAL FAILURE PATIENTS C Srinath*. Leeds Teaching Hospitals NHS Trust, Anaesthesia, Leeds, UK 10.1136/rapm-2019-ESRAABS2019.400 Background and aims End stage renal failure (ESRF) patients need vascular access for haemodialysis. Arterio-venous fistula (AVF) is most commonly used access for haemodialysis. AVF have high failure rate of 30–40% which could be due to failed maturation or thrombosis. The choice of anaesthetic Abstract ESRA19-0263 Figure 2 Abstracts A226 RAPM 2019;44(Suppl 1):A1–A276