The Erector Spinae Plane Block For Gastrointestinal Malignancy Pain Treatment (EGIPT)

Summary

This study will target patients with gastrointestinal (GI) malignancy who present to any of 4 Penn Medicine emergency departments (EDs) with intractable abdominal pain. We will offer eligible patients an erector spinae plane block (ESPB), a regional anesthesia technique which is already offered to such patients in the ED at the University of Pennsylvania Healthy System (UPHS), for their intractable abdominal pain. We will compare the outcomes of this prospective cohort of patients to a matched historical control of patients with GI malignancy who were treated in the ED during the same time period as recruitment, but who were not recruited to partake in the study and who were managed with standard of care. Opioid consumption as measured by total milligram morphine equivalents (MMEs) over a 24-hour period and hospital length of stay (LOS) will be compared between cohorts. Additionally, for the ESPB cohort, pain level pre/post ESPB, and functionality and satisfaction with pain management at 24 hours will also be examined.

Eligibility

Inclusion Criteria:

1. Patients age \> 18 years old with GI malignancy presenting to a Penn Medicine ED with intractable abdominal pain.
2. Same-day or recent CT scan of the abdomen / pelvis which demonstrates that the patient's abdominal pain can be reasonably attributed to a malignant source.

Exclusion Criteria:

1. Allergy to ropivacaine or history of local anesthetic systemic toxicity.
2. Pregnancy
3. Incarcerated
4. Patients being admitted for serial abdominal examinations to determine their surgical course.
5. Altered mental status or inability for patient to consent for the procedure
6. Hemodynamic instability
7. Previously enrolled in the study

Conditions3

Locations4 sites

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