Ultrasound-Guided Erector Spinae Plane Block versus Oblique Subcostal Transversus Abdominis Plane Block for Post-Operative Analgesia of Adult Patients Undergoing Laparoscopic Cholecystectomy

Abstract

Objective: To compare the relative effectiveness of Oblique subcostal transversus abdominis plane block with Erector spinae plane block in reliving post-operative pain in patients subjected to elective laparoscopic cholecystectomy. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital, Rawalpindi Pakistan, from Nov 2020 to Apr 2021. Methodology: Sixty-eight patients were equally divided into two groups, ESP and OSTAP (34 each). ESP-Group received a bilateral erector spinae block, and OSTAP-Group received a bilateral oblique subcostal transversus abdominis block. Ultrasound guidance was used for block execution in both Groups. Bupivacaine 0.375% 20 ml was used for each side of the block. Post-operatively, Acetaminophen 1g IV 8 hourly was given to all patients, and in addition, Tramadol was used as rescue analgesia. Endpoints included comparing total Tramadol usage and Numerical Rating Scale scores between respective Groups. Results: Post-operative Tramadol consumption in Group-ESP was 144.26±16.38 mg compared with 200.58±17.57 mg of the Group-OSTAP. This difference was significant (p<0.001). Pain scores measured by the Numerical Rating Scale remained lower in the ESP Group throughout the post-operative 24 hours. However, this difference started decreasing after the eighth postoperative hour. Conclusion: Both the blocks play a good role in multimodal analgesia, but the Ultrasound-guided ESP block reduced postoperative Tramadol consumption and pain scores more effectively than the OSTAP block after laparoscopic cholecystectomy surgery.

Keywords

• Erector spinae plane block
• Oblique subcostal transversusabdominis plane block
• Laparoscopic cholecystectomy