Comparative Study between Subcostal Transverses Abdominis Block and Erector Spinae Plane Block for Post-operative Opioid Sparing Analgesia in Laparoscopic Cholecystectomy Patient

Abstract

Background and Aim: Laparoscopic cholecystectomy is one of the most commonly performed minimally invasive intra abdominal surgeries to remove the diseased gallbladder. Though associated with complications like pneumoperitoneum. Major benefits include reduced postoperative pain and fewer wound related adverse effects. Growing need for opioid sparing analgesia has led to use of regional techniques for post-operative pain relief. Aim of this study is to compare quality and duration of post-operative analgesia between subcostal transverses abdominis block and erector spinae plane block. Methods: It is a prospective study, where 40 patients were randomly allocated into two groups of 20 each. All the patients received 40 ml of inj 0.25% bupivacaine + 10 mcg inj dexmedetomidine in total. Erector spinae plane (EPS) block was performed in one group of patients and other received sub costal transverses abdominis plane (SCTAP) block. Quality of post-operative analgesia is documented using visual analogue score (VAS) and duration being assessed by the need for rescue analgesia for the set duration of post-operative stay. Results: In the erector spinae plane block group the VAS is considerably lower compared to subcostal transverses abdominis block group. Need for rescue analgesia with NSAIDs was lower in erector spinae plane block group patients. No complications related to the block were documented in either group. Conclusion: In conclusion ultrasound guided bilateral erector spinae plane block provides analgesia superior to bilateral subcostal transverses abdominis plane block.