الفهرس 
Postoperative Pain
Introduction to ultrasoundOnly 14 pages are availabe for public view
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Abstract
Postoperative pain limits the intercostal and abdominal muscle activity resulting in reduced ventilation, prevention of cough and inability to expel secretions. This leads to postoperative pulmonary complications such as atelectasis and pneumonia especially in obese individuals because the excess body fat that lines the chest and occupies the abdomen limits the action of the respiratory muscles.(1) Ventral hernia repair surgery is associated with significant postoperative pain. A lot of modalities for pain relief have been described including opioids, and non-opioid analgesics as well as regional anesthesia. Post-operative pain in obese patients is challenging. Opioids, which represent the main stay for pain management, can lead to various adverse events such as nausea, Vomiting, Ventialtory depression and physical dependence. There for, regional anesthesia is often helpful in improving respiratory function and analgesia.(2),(3) The erector spinae plane block (ESP) is a paraspinal fascial plane block in which local anesthetic is administered between the erector spinae muscle and the transverse processes, blocking the dorsal and ventral rami of the thoracic and abdominal spinal nerves.(4)According to previous studies, ESP Block proved efficiency in postoperative pain control in many surgeries as breast surgeries, abdominal surgeries, spine surgeries and thoracic surgeries. Also provided lower pain score in patients with chronic shoulder pain and fracture ribs.(5),(6).