Journal of Yeungnam Medical Science

Original article

Anesthesiology and Pain Medicine
Quadratus lumborum block for postoperative pain management in patients undergoing ileostomy closure: a prospective, randomized controlled trial: Su Jin Kang, Soo Yeun Park, Jun Seok Park, Jinseok Yeo; J Yeungnam Med Sci. 2026;43:5. Published online December 19, 2025; DOI: https://doi.org/10.12701/jyms.2026.43.5

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Abstract PDF: Background
Quadratus lumborum (QL) block is used for multimodal analgesia following abdominal surgery. We introduced an ultrasound-guided QL block to treat postoperative pain for ileostomy closure. This study aimed to investigate the analgesic efficacy of the QL block compared to placebo after ileostomy closure.
Methods
Fifty-seven patients undergoing elective ileostomy closure were randomized (1:1) to the placebo or QL block group in this double-blind randomized controlled trial. After general anesthesia, a unilateral QL block was performed under ultrasound guidance. Opioid consumption and numeric rating scale (NRS, 0–10) pain scores were recorded at 2, 6, 12, 24, 48, and 72 hours postoperatively. The primary outcome was the NRS pain score at rest at 6 hours. Secondary outcomes included pain scores, rescue analgesics over 72 hours, Quality of Recovery-15 scores in 24 hours, complications, and length of hospital stay.
Results
Baseline characteristics were similar among the 54 patients (27 per group) who completed the study, excluding three who dropped out. The QL block did not reduce NRS pain scores at rest at 6 hours (median [interquartile range], 5 [4–6] vs. 5 [3–6]; p=0.78). Over the 72-hour postoperative period, pain scores at rest remained comparable between the groups, while the QL group showed slightly lower movement-induced pain at certain time points. The QL group required fewer analgesics and antiemetics at certain intervals, but the total opioid use, length of hospital stay, and quality of recovery were not significantly different.
Conclusion
The QL block showed no meaningful advantage in postoperative analgesia compared to placebo for ileostomy closures.

Review article

Anesthesiology and Pain Medicine
Regional analgesia for postoperative pain control after thoracic surgery: a narrative review: Sang-Jin Park, Eun Kyung Choi; J Yeungnam Med Sci. 2025;42:80. Published online December 4, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.80

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Abstract PDF: Effective management of post-thoracotomy pain is essential to prevent pulmonary complications and reduce the risk of developing chronic pain syndrome. Although systemic opioids remain a common option, their use is limited by significant adverse effects, making regional analgesia the cornerstone of postoperative pain management. Thoracic epidural analgesia, historically regarded as the gold standard, provides potent postoperative pain relief but carries risks of hypotension and, in rare cases, severe neurological events. Thoracic paravertebral block (PVB) has emerged as the primary alternative, offering comparable analgesic efficacy and an improved safety profile, particularly in maintaining hemodynamic stability. However, PVB is technically demanding and associated with a higher failure rate and localized procedural complications such as pneumothorax. Fascial plane blocks have recently been developed to prioritize safety. The erector spinae plane block is technically simpler, using the transverse process as a “bony backstop” to minimize the risk of pleural injury; however, its analgesic potency may be lower than that of PVB. The intertransverse process block seeks to combine the efficacy of PVB with enhanced safety; however, supporting evidence remains limited. Alternative regional techniques, such as serratus anterior plane block, intercostal nerve block, and continuous wound instillation, typically provide insufficient analgesia for the comprehensive pain associated with open thoracotomy. No regional analgesic technique has demonstrated universal superiority. The optimal approach should be individualized, balancing the distinct risk–benefit profile of each block with patient comorbidities, surgical factors, and institutional expertise.

Original article

Anesthesiology and Pain Medicine
Comparison of the efficacy of erector spinae plane block according to the difference in bupivacaine concentrations for analgesia after laparoscopic cholecystectomy: a retrospective study: Yoo Jung Park, Sujung Chu, Eunju Yu, Jin Deok Joo; J Yeungnam Med Sci. 2023;40(2):172-178. Published online September 23, 2022; DOI: https://doi.org/10.12701/jyms.2022.00500

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Abstract PDF

Background
Laparoscopic cholecystectomy (LC) is a noninvasive surgery, but postoperative pain is a major problem. Studies have indicated that erector spinae plane block (ESPB) has an analgesic effect after LC. We aimed to compare the efficacy of different ESPB anesthetic concentrations in pain control in patients with LC.
Methods
This retrospective study included patients aged 20 to 75 years scheduled for LC with the American Society of Anesthesiologists physical status classification I or II. ESPB was administered using 0.375% bupivacaine in group 1 and 0.25% in group 2. Both groups received general anesthesia. Postoperative tramadol consumption and pain scores were compared and intraoperative and postoperative fentanyl requirements in the postanesthesia care unit (PACU) were measured.
Results
Eighty-five patients were included in this analysis. Tramadol consumption in the first 12 hours, second 12 hours, and total 24 hours was similar between groups (p>0.05). The differences between postoperative numeric rating scale (NRS) scores at rest did not differ significantly. The postoperative NRS scores upon bodily movement were not statistically different between the two groups, except at 12 hours. The mean intraoperative and postoperative fentanyl requirements in the PACU were similar. The difference in the requirement for rescue analgesics was not statistically significant (p=0.788).
Conclusion
Ultrasound-guided ESPB performed with different bupivacaine concentrations was effective in both groups for LC analgesia, with similar opioid consumption. A lower concentration of local anesthetic can be helpful for the safety of regional anesthesia and is recommended for the analgesic effect of ESPB in LC.

Citations

Citations to this article as recorded by

Comparison of erector spinae plane block and rhomboid intercostal block for postoperative pain management in patients undergoing unilateral breast surgery
Gülnihal Avcı, Sevim Cesur Okan, Hadi Ufuk Yörükoğlu, Can Aksu, Alparslan Kuş
BMC Anesthesiology.2026;[Epub] CrossRef
Overview of ultrasound-guided plane blocks performed within the scope of multimodal anesthesia applications in lower and upper abdominal surgeries
Mert Yetgin, Hülya Sungurtekin, Hale Yetgin
Pamukkale Medical Journal.2025; 18(4): 21. CrossRef
Surgeon-Delivered Bupivacaine Achieves Analgesic Efficacy Comparable to ESP and TAP Blocks in Laparoscopic Cholecystectomy: A Randomized Controlled Trial
Melih Can Gül, Ramazan Koray Akbudak
Surgeries.2025; 6(4): 90. CrossRef
Bilateral erector spinae plane block on opioid-sparing effect in upper abdominal surgery: study protocol for a bi-center prospective randomized controlled trial
Changzhen Geng, Li Wang, Yaping Shi, Xinnan Shi, Hanyi Zhao, Ya Huang, Qiufang Ji, Yuanqiang Dai, Tao Xu
Trials.2024;[Epub] CrossRef
Erector Spinae Plane Block with 0.375% Bupivacaine vs 0.25% Bupivacaine in Laparoscopic Cholecystectomy Patients: Effect on Postoperative Analgesia, Shoulder Tip Pain, and Postoperative Stress Markers
Mohammad Mohsin, Asna Jamal, Ali Saloda, Kharat M Batt, Shantnu Bhanwala
Research & Innovation in Anesthesia.2024; 9(1): 1. CrossRef

Original Article

Anesthesiology and Pain Medicine
Effect of preoperative pregabalin on postoperative pain after gastrectomy: Chan Yoon Park, Sol Hee Park, Dong Gun Lim, Eun Kyung Choi; Yeungnam Univ J Med. 2018;35(1):40-44. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.40

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Abstract PDF

Background
Pregabalin has been studied as a single or multimodal analgesic drug for postoperative pain management in different types of surgeries. We evaluated the analgesic effect of 150 mg of pregabalin in resolving post-gastrectomy pain.
Methods
Forty-four patients were randomized into two groups: a pregabalin group that received oral pregabalin (150 mg) 2 h before anesthetic induction, and a control group that received placebo tablets at the same time. Data on postoperative pain intensity (visual analog scale [VAS], at 30 min, 2 h, 4 h, and 24 h), consumption of fentanyl in patient-controlled analgesia (PCA), and the proportion of patients requiring rescue analgesics at different time intervals (0-2 h, 2-4 h, and 4-24 h) were collected during the 24 h postoperative period.
Results
The VAS scores did not show significant differences at any time point and consumption of fentanyl in PCA and the proportion of patients requiring rescue analgesics did not differ between the two groups. The groups did not differ in the occurrence of dizziness, sedation, and dry mouth.
Conclusion
A preoperative 150 mg dose of pregabalin exerts no effect on acute pain after gastrectomy.

Citations

Citations to this article as recorded by

Treatment of acute postoperative pain in patients undergoing open abdominal aortic repair (current state of the problem)
Anzhelika V. Kozhanova, Georgy P. Plotnikov
Regional Anesthesia and Acute Pain Management.2022; 16(1): 45. CrossRef
Comparison of premedication with 75 mg and 150 mg pregabalin for postoperative analgesia in total hysterectomy patients - A randomised control trial
Ajish Varghese Cheruvathur, Dilshad Thondi Parambil, Saurabh Vig, Salman Mohammed Kutty Chenath, Priyadharshini Nagaraj, Krupa Mulgaonkar, S Jeevithan
Indian Journal of Clinical Anaesthesia.2022; 9(4): 467. CrossRef

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