Comparative study of the efficacy of ultrasound-guided erector spinae block and oblique subcostal transversus abdominis plane block for postoperative analgesia after laparoscopic cholecystectomy

Abstract

Background Laparoscopic cholecystectomy has changed the surgical management of cholelithiasis and has become the mainstay of the management of uncomplicated gallstone disease. Adequate postoperative pain relief leading to early ambulation is imperative for patient satisfaction and early discharge of the patient. The use of ultrasound in anesthetic practice has ushered in a new era of ultrasound-guided blocks for postoperative analgesia, replacing the conventional methods. This study compares two modalities of postoperative pain relief, namely the oblique subcostal transversus abdominis plane block and the newer erector spinae plane block for patients undergoing laparoscopic cholecystectomy. Results Sixty patients between the age group 18 to 75 of ASA grades I, II, and III were enrolled in the study. The erector spinae plane block group showed lower numerical rating scores up to 12 h, a longer time period for the requirement of first rescue analgesic, and lower total analgesic consumption postoperatively compared to the oblique subcostal transversus abdominis plane block group. Both blocks were found to have minimal side effects. Conclusions The erector spinae plane block is superior to the oblique subcostal transversus abdominis plane block in that it affords lower pain scores and a longer duration of analgesia and reduces the total analgesic consumption after laparoscopic cholecystectomy. Trial registration Clinical Trials Registry of India/CTRI/2020/10/028603/ registered on 23 October 2020 http://ctri.nic.in/Clinicaltrials/rmaindet.php?trialid=47807&EncHid=18303.55562&modid=1&compid=19