Abstract :
Aim & Objective: Laparoscopic cholecystectomy (LC) is a commonly performed minimally invasive
surgery. LC can cause moderate to severe postoperative pain due to small keyhole entries on the abdominal
wall. The oblique subcostal transversus abdominis plane block (OSTAP) has been used for postoperative
analgesia after LC but found not so effective. Our aim is to compare the effectiveness of erector spinae
block with OSTAP block for postop analgesia after LC.
Materials and Methods: This prospective, randomized study was conducted at a tertiary care hospital.
Seventy patients, 18 to 65 years old posted for LC were divided into two equal groups of 35 each. Erector
spinae plane block was performed in the ESP group and oblique subcostal transverses abdominis plane
block was performed in the OSTAP group. Postoperative rescue analgesic consumption, time to 1st rescue
analgesia, numerical rating score (NRS), and any complications in 1st 24 hrs between the groups were
compared.
Results: Postoperative rescue analgesic (paracetamol) consumption was 1.9 0.85gm in ESP group and
2.84 0.29gm in OSTAP group which was statistically significant. Time to 1st rescue analgesia request
was 360.34 28.94 mins in ESP group and 280.51 45.66 mins in OSTAP group which was statistically
significant. Although NRS scores at almost all time-points were lower in the ESP group compared to
OSTAP block, the difference was significant in 1st 6 hrs.
Conclusion: Ultrasound guided ESP block reduced postoperative rescue analgesic consumption and pain
scores more effectively than OSTAP block after laparoscopic cholecystectomy surgery.
Keyword :
Cholecystectomy, Laparoscopic, Pain management, Erector spinae plane block, Oblique subcostal transversus
abdominis plane block.