Evaluation of postoperative analgesia of erector spinae plane block in elective laparoscopic cholecystectomy: a randomized controlled trial.

Abstract

Background: Only a few studies have evaluated the analgesic effect of erector spinae plane block (ESPB) for laparoscopic cholecystectomy surgery. We aimed to evaluate the analgesic effect of ESPB in patients undergoing laparoscopic cholecystectomy. Methods: Seventy-five patients of American Society of Anaesthesiologists (ASA) grade I/II aged 18-60 years undergoing elective laparoscopic cholecystectomy were enrolled and were randomly assigned to group C or T. Patients in group C were given general anaesthesia alone, and patients in group T were given bilateral ultrasound-guided ESPB followed by general anaesthesia. The primary objective was to compare total 24 hours postoperative analgesic consumption of tramadol, and the secondary objective was to indicate the need for rescue analgesia and numeric pain rating scores (NRSs) at rest and on movement between the groups. Results: Sixty-six patients were included for final analysis. The total tramadol consumption in 24 hours postoperative period for group T was 105.21±60.18 mg and for group C was 178.12±54.3 mg, and the difference was statistically highly significant (P = .0001). The need for rescue analgesia (fentanyl) was also statistically significantly lower in group T compared to group C (0.91±5.22 mcg vs 13.64±23.82 mcg, P = .002). The postoperative NRS at ½, 2, 4, 6, and 8 hours at rest and on movement was statistically lower in group T than group C, although this difference was not of clinical significance. Conclusion: In patients undergoing laparoscopic cholecystectomy, bilateral ultrasound-guided ESPB provided effective analgesia as it reduced the total tramadol consumption and the need for rescue analgesia in 24 hours postoperative period.