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The following is a summary of “Impact of Fascial Plane Block on Postoperative Length of Stay and Opioid Use Among Colectomy Patients Within an Established Enhanced Recovery After Surgery Program: A Retrospective Cohort Study,” published in the February 2025 issue of Journal of Pain Research by Khersonsky et al.
The growing use of fascial plane blocks has shown unclear effects on hospital length of stay (LOS) and opioid use within enhanced recovery after surgery (ERAS) pathways.
Researchers conducted a retrospective study to analyze the impact of fascial plane blocks on postoperative LOS and opioid use in colorectal surgery within a hospital-based ERAS program.
They utilized electronic health record data from a large, integrated health care system with an established ERAS program in Northern California. The study included adults who underwent non-emergent colectomy surgery, either laparoscopic (n=5,496) or non-laparoscopic (n=708), between January 1, 2015, and May 20, 2021. The primary exposure was anesthesia type: general anesthesia with a long-acting fascial plane block, general anesthesia with a short-acting fascial plane block, or general anesthesia alone. Outcomes measured included postoperative LOS and average daily morphine milligram equivalents (MME) for up to 3 days after surgery.
The results showed that most individuals were over 50 years old (86% laparoscopic; 83% non-laparoscopic), female (52% laparoscopic; 58% non-laparoscopic), and non-Hispanic White (64% laparoscopic; 62% non-laparoscopic) and LOS did not differ significantly across anesthesia types. In laparoscopic surgery, short-acting fascial plane blocks were linked to higher MME (RE: 1.14, [95% CI: 1.03–1.25], P -value=0.01). In non-laparoscopic surgery, long-acting fascial plane blocks were associated with lower MME (RE: 0.63, [95% CI: 0.42–0.93], P -value=0.02).
Investigators concluded that while fascial plane blocks did not affect postoperative LOS, long-acting blocks reduced overall postoperative opioid use in non-laparoscopic surgery.
