A comparative evaluation of ultrasound guided dual transversus abdominis plane block versus erector spinae plane block for postoperative analgesia in patients undergoing laparoscopic cholecystectomy: A randomised prospective study

Abstract

: Effective pain control after laparoscopic cholecystectomy (LC) is crucial for early patient mobilization, facilitating a speedy recovery and avoiding several complications. Ultrasound (USG) guided bilateral dual transversus abdominis plane block (DTAPB) and erector spinae plane block (ESPB) are effective for providing postoperative pain relief after LC.A prospective randomised, study comprising of 100 patients posted for elective LC. To compare the effectiveness of USG-guided DTAPB and ESPB for providing postoperative pain relief in patients undergoing LC. A total of 100 patients aged 18-70 years, were included in the study and divided into two groups of 50 patients each. Group DTAPB received bilateral DTAPB and group ESPB received bilateral ESPB, using 50 ml of 0.25% ropivacaine with 8 mgs of dexamethasone. Post operative visual analogue score (VAS) score, time to first analgesia request, total number of analgesic doses required in 24 hours (hrs) and complications if any were noted. VAS score was higher in DTAPB group than ESPB group at 1,2,6,8 and 14 hrs. In DTAPB group patients requested analgesia after an average of 8 ±2.0 hrs, whereas in ESPB group they requested after 12 ± 3.16 hrs. In ESPB group 45 patients needed single analgesic dose and only 5 needed second analgesic doses. However, in DTAPB group 35 patients received single and 15 patients received second analgesic dose. Side effects were comparable in both the groups.USG-guided bilateral ESPB with 50 ml of 0.25% ropivacaine plus dexamethasone is an effective approach in reducing postoperative pain following LC.