Ultrasonografi Eşliğinde Erektör Spina Kasının Farklı Torakal Seviyelerde ve Farklı Pozisyonlarda Cilde Olan Uzaklığının Karşılaştırılması

Year 2024, Volume: 21 Issue: 2, 260 - 265, 29.08.2024

Muhammed Halit Satıcı , Orhan Binici

https://doi.org/10.35440/hutfd.1489020

Abstract

Amaç: Erektör spina düzlem bloğu çeşitli torasik seviyelerde ve farklı pozisyonlarda gerçekleştirilebilir. Çalışmamız, erektör spina kasının deriden optimal mesafesini belirlemeyi ve farklı torakal seviye ve pozisyonlarda en iyi ultrasonografi görüntüleme kalitesini belirlemeyi amaçladı.
Materyal ve Metod: Erektör spina kası, yüksek frekanslı 10-15 MHz doğrusal ultrason probu kullanılarak farklı torakal seviyelerde (T1-T2, T5-T6, T11-T12) ve çeşitli pozisyonlarda (yan, oturma ve yüzüstü) konumlandırıldı.
Bulgular: Erektör spina kasının cilde yakınlığının T1-T2 ve T11-T12 seviyelerine göre T5-T6 seviyesinde anlamlı olarak daha yakın olduğu görüldü (p=0.001; p<0.01). Yüzüstü pozisyonda erektör spina kasının cilde mesafesi yan ve oturma pozisyonlarına göre anlamlı derecede düşüktü (p=0.001; p<0.01).
Sonuç: T5-T6 torakal seviyede ve yüzüstü pozisyonda uygulanacak erektöt spina plan bloğunda erektör spina kası cilde daha yakın olup ultrason görüntüsü daha iyidir.

Keywords

Erektör spina düzlem bloğu, periferik sinir bloğu, ultrasonografi

Ethical Statement

Bu çalışma Harran Üniversitesi Tıp Fakültesi klinik araştırma etik kurulu tarafından onaylandı (Tarih: 06.09.2021, Sayı: 21.15.13).

Supporting Institution

Yok.

Thanks

Yok.

Comparison of the Distance of the Erector Spinae Muscle from the Skin at Different Thoracal Levels and Different Positions Under Ultrasonography

Abstract

Background: The erector spinae plane block can be executed at various thoracic levels and in different positions. Our study aimed to determine the optimal distance of the erector spinae muscle from the skin and to identify the best ultrasonography imaging quality across different thoracic levels and positions.
Materials and Methods: The erector spinae muscle was located using a high-frequency 10-15 MHz linear ultrasound probe at distinct thoracic levels (T1-T2, T5-T6, T11-T12) and in various positions (lateral, sitting, and prone).
Results: The proximity of the erector spinae muscle to the skin was found to be significantly closer at the T5-T6 level compared to the T1-T2 and T11-T12 levels (p = 0.001; p < 0.01). In the prone position, the distance of the erector spinae muscle to the skin was significantly lower than in the lateral and sitting positions (p = 0.001; p < 0.01).
Conclusions: In an ESPB to be applied at the T5-T6 thoracal level and in the prone position, the erector spinae muscle is closer to the skin, and the ultrasound image is better.

Keywords

Erector spinae plane block, peripheral nerve block, ultrasonography

References

• 1. Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The Erector Spinae Plane Block: A Novel Analgesic Technique In Thorac-ic Neuropathic Pain. Regional Anesthesia Pain Medicine. 2016;41(5):621–627.
• 2. Tsui BCH, FonsecaA, MunsheyF, McFadyenG, Caruso TJ. The erector spinae plane (ESP) block: A pooled review of 242 cases. Journal of clinical anesthesia. 2019;53:29-34.
• 3. KotP, Rodriguez P, Granell M, Cano B, Rovira L, Moraleset J, et al. The erector spinae plane block: A narrative review. Korean journal of Anesthesiology. 2019;72(3):209-220.
• 4. Luis-Navarro JC, Seda-Guzmán M, Luis-Moreno C, Chin KJ. Erector spinae plane block in abdominal surgery: Case se-ries. Indian Journal of Anaesthesia. 2018;62(7):549-54.
• 5. Tulgar S, Selvi O, Kapakli MS. Erector Spinae Plane Block for Different Laparoscopic Abdominal Surgeries: Case Se-ries. Case Rep Anesthesiol. 2018;18:2108:3947281.
• 6. Chin KJ, AdhikaryS, SarwaniN, Forero M. The analgesic efficacy of pre-operative bilateral erector spinae plane (ESP) blocks in patients having ventral hernia repair. An-aesthesia. 2017;72(4):452-460.
• 7. Dautzenberg KHW, Zegers MJ, Bleeker CP, Tan ECT, Vissers KCP, Van Geffen GJ, et al. Unpredictable Injectate Spread of the Erector Spinae Plane Block in Human Cadavers. An-esthesia Analgesia. 2019;129(5):e163-e166.
• 8. Schwartzmann A, Peng P, Maciel MA, Forero M. Mecha-nism of the erector spinae plane block: insights from a magnetic resonance imaging study. Canadian Journal of Anaesthesia. 2018;65(10):1165-1166.
• 9. Sharma S, Arora S, Jafra A, Singh G. Efficacy of erector spinae plane block for postoperative analgesia in total mastectomy and axillary clearance: A randomized con-trolled trial. Saudi Journal of Anaesthesia. 2020;14(2):186-191.
• 10. Kose HC, Kose SG, Thomas DT. Lumbar versus thoracic erector spinae plane block: Similar nomenclature, different mechanism of action. Journal of clinical anesthesia. 2018; 48:1.
• 11. Ahiskalioglu A, Alici HA, Ari MA. Ultrasound guided low thoracic erector spinae plane block for management of acute herpes zoster. Journal of clinical anesthesia. 2018; 45:60-61.
• 12. Chin KJ, Forero M, Adhikary SD. Reply to Dr Ueshima and Dr Murouchi. Regional Anesthesia Pain Medicine. 2017;42(1):124-125.
• 13. Ueshima H, Otake H. Clinical experiences of ultrasound-guided erector spinae plane block for thoracic vertebra sur-gery. Journal of clinical anesthesia. 2017;38:137.
• 14. Hernandez MA, Palazzi L, Lapalma J, Cravero J. Erector spinae plane block for inguinal hernia repair in preterm in-fants. PaediatricAnaesthesia. 2018;28(3):298-299.
• 15. Aksu C, Gürkan Y. Aksu approach for lumbar erector spinae plane block for pediatric surgeries. Journal of clinical anes-thesia. 2019;54:74-75.
• 16. Ababou A, Marzouk N, Mosading A, Sbihi A. The effects of arm position on onsetand duration of axillary brachial plex-us block. Anesthesia Analgesia. 2007;104(4):980-1.
• 17. Zaragoza-Lemus G, Hernández-Gasca V, Espinosa-Gutiérrez A. Ultrasound-guided continuous infraclavicular block for hand surgery: technical report arm position for perineural catheter placement. Cir Cir. 2015;83(1):15-22.
• 18. Alici HA, Ahiskalioglu A, Aydin ME, Ahiskalioglu EO, Celik M. High volume single injection lumbar erector spinae plane block provides effective analgesia for lower extremi-ty herpes zoster. Journal of clinical anesthesia. 2019;54:136-137.
• 19. De Cassai A, Andreatta G, Bonvicini D, Boscolo A, Munari M, Navalesi P. Injectate spread in ESP block: A review of anatomical investigations. Journal of clinical anesthesia. 2020;61:109669.