Evaluation of efficacy of ultrasound guided erector spinae plane block and oblique subcostal transversus abdominis plane block for postoperative analgesia in laparoscopic cholecystectomy

Abstract

Laparoscopic cholecystectomy (LC) is a commonly performed minimally invasive surgery. LC can cause moderate to severe postoperative pain due to small keyhole entries on the abdominal wall. The oblique subcostal transversus abdominis plane block (OSTAP) has been used for postoperative analgesia after LC but found not so effective. Our aim is to compare the effectiveness of erector spinae block with OSTAP block for postop analgesia after LC. Materials and Methods: This prospective, randomized study was conducted at a tertiary care hospital. Seventy patients, 18 to 65 years old posted for LC were divided into two equal groups of 35 each. Erector spinae plane block was performed in the ESP group and oblique subcostal transverses abdominis plane block was performed in the OSTAP group. Postoperative rescue analgesic consumption, time to 1 st rescue analgesia, numerical rating score (NRS), and any complications in 1 st 24 hrs between the groups were compared. Results: Postoperative rescue analgesic (paracetamol) consumption was 1.9± 0.85gm in ESP group and 2.84 ± 0.29gm in OSTAP group which was statistically significant. Time to 1 st rescue analgesia request was 360.34±28.94 mins in ESP group and 280.51±45.66 mins in OSTAP group which was statistically significant. Although NRS scores at almost all time-points were lower in the ESP group compared to OSTAP block, the difference was significant in 1 st 6 hrs. Conclusion: Ultrasound guided ESP block reduced postoperative rescue analgesic consumption and pain scores more effectively than OSTAP block after laparoscopic cholecystectomy surgery.

A Comparative Evaluation of Post-operative Pain Management Using Erector Spinae Plane Block and Oblique Transverse Abdominis Plane Block in Patients Undergoing Laparoscopic Cholecystectomy

“…In the present study, the patients in group O demanded tramadol significantly more times than those in group E, and the first analgesic demand was significantly delayed in group E (p < 0.001). These results are similar to the above three studies [ 11 - 13 ]. Shahid et al conducted a study comparing the effects of paracetamol and tramadol on postoperative pain and found that the use of tramadol significantly increases the incidence of PONV.…”

“…In another study conducted by Routray et al, it was concluded that rescue analgesic paracetamol consumption was lower in the ESPB group and the time to the first rescue analgesia request was longer in the ESPB group. This difference was found to be statistically significant; the results of which are persistent to the findings of the present study [ 11 ]. In a study conducted by Ozdemir et al, it was concluded that intra-operative and postoperative fentanyl requirements were lower in ESPB and the time to first rescue analgesic need was longer in ESPB.…”