Comparison of Ultrasound-Guided Erector Spinae Plane Block and Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia after Laparoscopic Cholecystectomy: A Randomized, Controlled Trial

Abstract

Purpose

Laparoscopic cholecystectomy causes moderate to severe pain despite its minimally invasive nature. This study was performed to compare the efficacy of the bilateral erector spinae plane block (ESPB) and the subcostal transversus abdominis plane block (STAPB) under ultrasound guidance.

Methods

64 patients were included in this prospective, randomized study. The patients were allocated into two groups as those receiving ESPB (n = 32) and those receiving STAPB (n = 32). Pain scores at rest and during movement, fentanyl requirement, postoperative walking time, and duration of hospital stay were compared. The complications which related to block were also recorded.

Results

In the ESPB group, the Numeric Rating Scale (NRS) scores at rest were lower at hour 0 [at the time of post-anesthetic care unit (PACU) admission] and postoperative hours 2, 4, 6, and 12 (p < 0.05). In the same group, the NRS scores at movement were lower at hours 0, 2, 4, 6, 12, and 24 (p < 0.05). In the ESPB group, the time to first analgesic need was longer (p < 0.05), intraoperative and postoperative Fentanyl requirement (p < 0.0001 for both) and PACU rescue analgesic requirement were lower (p < 0.05), the lengths of PACU and hospital stay were shorter (p < 0.0001), and unassisted walking time was shorter (p < 0.0001). There were no complications related to the block in either group.

Conclusion

Bilateral ultrasound-guided ESPB provides superior analgesia after laparoscopic cholecystectomy surgery compared to STAPB and further reduces unaided walking time and hospital stay.

Keywords:

• Analgesia
• discharge time
• erector spinae plane block
• laparoscopic cholecystectomy
• walking time
• subcostal transversus abdominis plane block

This article is referred to by:

Erector Spinae Plane Block Enhances Multimodal Analgesia for Laparoscopic Cholecystectomy

Disclosure statement

The authors declare that they have no competing interest.

Study design: H.O., O.K.; Administration of block: H.O.; Data collection: H.O., O.K., E.T.; Data analysis: H.O., O.K., C.A.; Writing the first draft of the paper: H.O., O.K.

Ethical considerations and consent

Our study was carried out at Baskent University Konya Application and Research Center after obtaining ethical permission from the Başkent University ethics committee (KA 19/152).