Effectiveness of Ultrasound-Guided Retrolaminar Block and Erector Spinae Plane Block in Retroperitoneal Laparoscopic Surgery: A Randomized Controlled Trial.

Abstract

PurposeRetrolaminar block (RLB) and erector spine plane block (ESPB) share a similar block site, but their analgesia principle may differ. This study compared the postoperative analgesic effects of ultrasound-guided RLB and ESPB for retroperitoneal laparoscopic surgery.Patients and MethodsThe study included patients who scheduled for laparoscopic nephrectomy from July 2020 to January 2021. Patients in RLB group received a three-point block at the posterior surface of T8-T10 lamina, and those in ESPB group received at the T9 level. The primary result was the score of visual analogue scale (VAS). Secondary results included information on intraoperative and postoperative analgesia consumption and rescue analgesia usage, skin temperature, serum interleukin (IL)-1β, prostaglandin E2 (PGE2) level and the occurrence of safety events.ResultsThere was no significant difference between the two groups in the postoperative VAS scores at both the rest and cough state (All P>0.05). The skin surface temperature of the affected side and the healthy side in ESPB group was higher than that in the RLB group at the end of the surgery (P=0.002) and after surgery (P=0.016). The RLB group had a higher ephedrine usage than the ESPB group (P=0.027). Compared with the ESPB group, the RLB group had a shorter time to exhaust (P=0.045) and lower serum IL-1β level (P=0.049). Patients in neither group developed severe adverse event.ConclusionUltrasound-guided RLB and ESPB can provide safe and effective postoperative analgesia for retroperitoneal laparoscopic surgery. ESPB has more stable intraoperative hemodynamics, while RLB has more potential research value for patients’ rapid recovery.