Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Researcher Pia Therese Jæger, Rigshospitalet Copenhagen, Denmark
- Second opponent: Professor Gunnvald Kvarstein, UiT - The Arctic University of Norway, Tromsø
- Third member and chair of the evaluation committee: Professor Audun Stubhaug, University of Oslo
Chair of the Defence
Professor II Torsten Eken, University of Oslo
Principal Supervisor
Professor Ann-Chatrin Linqvist Leonardsen, University of South-Eastern Norway
Summary
Evidence suggests that inadequate pain relief after surgery negatively affects recovery, health-related quality of life and return to normal function and leads to risk of complications and a higher risk of persistent pain. The use of site-specific regional anaesthesia techniques is recommended for the management of postoperative pain in a variety of surgical procedures.
This thesis aimed to examine the clinical effects of three specific fascial blocks: the transversus abdominis plane (TAP) block, the anterior quadratus lumborum block (QLB) and the erector spinae plane block (ESPB), with the overall hypothesis that fascial nerve blocks provides an added postoperative analgesic effect after abdominal surgery.
In addition, a descriptive magnetic resonance imaging (MRI) study was performed to elucidate the anatomical mechanism behind an ESPB.
In Study 1, a randomised controlled trial (RCT) evaluating the postoperative analgesic efficacy and side effects of the TAP block versus the anterior QLB after laparoscopic inguinal hernia repair, was conducted. The outcome measures were postoperative opioid consumption, postoperative pain scores, nausea and sedation scores. No significant differences between the two regional anaesthesia techniques were found.
Study 2 was an analysis of local anaesthetic spread after an ESPB in healthy volunteers using MRI as the imaging modality. Results showed the injectate spreading to pertinent neural structures, and provided important insight into the mechanisms behind an ESPB.
In Study 3, we evaluated the postoperative analgesic efficacy of an ESPB compared with a placebo after laparoscopic ventral hernia repair. The study was a RCT looking at rescue opioid consumption, pain scores, and recovery scores as outcome measures. There was no superior analgesic effect of an ESPB compared to the placebo at the injection site studied. We concluded that further studies with lower injection sites is needed.
Additional information
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