Journal of Surgery and Anesthesia

Abstract

Randomised Controlled Trial for Evaluation of Post Operative Analgesia after Ultrasound Guided Oblique Subcostal Transverse Abdominis Plane Block versus Erector Spinae Plane Block in Patients Undergoing Laparoscopic Cholecystectomy under General Anaesthesia

Shweta Mahaja*

Objectives: Despite laparoscopic cholecystectomy minimally invasive nature, it is not without pain. Considering the studies and facts mentioned before in the text we have planned to study the comparative efficacy of ultrasound guided bilateral oblique subcostal transverse abdominis plane block with bilateral erector spinae plane block in post operative analgesia in patients undergoing laparoscopic cholecystectomy.

Methods: The randomised controlled study was conducted at Indira Gandhi Medical College, Shimla, India, from March 2020 to March 2021. Patients were given blocks according to the computer-generated randomisation 30 minutes before shifting to the operation theatre. Group A received B/L Transversus Abdominis Plane (TAP) and group B received B/L ESP block. Patient VAS score, Numeric Rating Scale (NRS) score and demand of rescue analgesia with patient satisfaction was recorded for 48 hrs post-operatively.

Results: A total of 70 patients were included (35 in each group). In the post-operative period, the mean Visual Analog Scale (VAS) scores were statistically significant up to 4 hours postoperatively between the two groups with significantly lower VAS scores in Group B than in Group A. The mean time of first analgesic requirement in group A and group B was 3.83 ± 1.2 and 6.79 ± 4.2 hours respectively. Erector Spinae Plane Block (ESP) group received lesser doses of rescue analgesic as compared to OSTAP group showing better analgesia in ESP than Oblique Subcostal Transversus Abdominis Plane Block (OSTAP).

Conclusion: Both TAP and ESP blocks can be used to provide post-operative analgesia with stable intraoperative hemodynamics with no complications in laparoscopic cholecystectomy. However, ESP as compared to OSTAP block has lower VAS scores, lesser demand for rescue analgesic and prolonged duration of analgesia. ESP is simple, easier to learn and perform and provides better patient satisfaction without causing any noticeable side effects.

Published Date: 2023-12-20; Received Date: 2023-11-20