Analgesic effect of ultrasound-guided erector spinae plane block(ESPB) in general anesthesia for cesarean section: A randomized controlled trial

Background: The analgesic effects of the erector spinae plane block in general anesthesia for cesarean section and the recovery from puerperae remain unclear. Methods: : Sixty patients with contraindications for spinal anesthesia who required general anesthesia for cesarean section were enrolled and randomly divided into the erector spinal plane block (ESPB) combined with general anesthesia group (group E) and the general anesthesia group (group G). Group E received bilateral ESPB (20 ml of 0.25% ropivacaine on each side) under ultrasound guidance 30 min before general anesthesia. The heart rate (HR), mean arterial pressure (MAP) were recorded 10 min before the start of anesthesia (T0), at the induction of anesthesia (T1), at skin incision (T2), fetal delivery (T3), and immediately after surgery (T4). Intraoperative anesthesia dosage, fetal delivery time, and puerperae emergence time were also recorded. Visual analog scale (VAS) and Bruggrman comfort scale (BCS) scores at 2h, 6h, 12h, and 24h after operation were compared between the two groups. Number of patient-controlled intravenous analgesia (PCIA) boluses, and adverse reactions were also recorded. Results: : The MAP and HR of T2 and T3 in group G were significantly increased compared with T1 (P<0.05), as well as with those in group E at the same time point (P<0.05); compared with group G, the doses of propofol and remifentanil were significantly reduced (P<0.0001), the emergence time of the puerpera was shortened (P=0.003), the VAS score at 2h and 6h after the operation was reduced, the BCS score was increased (P<0.05), the number of PCIA boluses was reduced (P<0.001), and the incidence of nausea and vomiting significant decreased (P=0.014). Conclusion: Ultrasound-guided ESPB applied to general anesthesia for cesarean section can significantly reduce the required dose of general anesthetic drugs, shorten the recovery time of puerperae, and improve postoperative analgesia.