A Comparative Evaluation of Post-operative Pain Management Using Erector Spinae Plane Block and Oblique Transverse Abdominis Plane Block in Patients Undergoing Laparoscopic Cholecystectomy

Introduction Acute pain following laparoscopic surgeries interferes with the rehabilitation of the patient. Knowledge about the pain pathway from a particular area helps in blocking pain transmission at different sites. Ultrasonography (USG)-guided peripheral nerve blocks help in controlling pain be...

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Published in:Curēus (Palo Alto, CA) CA), 2023-03, Vol.15 (3), p.e35750-e35750
Main Authors: Mounika, Vaddamanu, Sahu, Lingaraj, Mishra, Krishna, Mohapatra, Partha S
Format: Article
Language:English
Subjects:
Analgesics
Anesthesia
Anesthesiology
Cholecystectomy
Dissection
Drug dosages
General Surgery
Laparoscopy
Medical personnel
Narcotics
Pain Management
Patients
Postoperative period
Surgery
Ultrasonic imaging
Vertebrae
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Summary:Introduction Acute pain following laparoscopic surgeries interferes with the rehabilitation of the patient. Knowledge about the pain pathway from a particular area helps in blocking pain transmission at different sites. Ultrasonography (USG)-guided peripheral nerve blocks help in controlling pain better than non-steroidal anti-inflammatory drugs (NSAIDS) and opioids since they directly act by interrupting the pain pathway and interfere less with the physiology of the body. This study was planned with the objectives to evaluate the analgesic efficacy of USG-guided erector spinae plane block (ESPB) and oblique subcostal transversus abdominis plane (OSTAP) block in patients undergoing elective laparoscopic cholecystectomy, to compare the analgesic requirements in both groups, and to compare the VAS scores in both groups. Materials and methods A total of 138 patients were randomized into two groups, with 69 patients in each group, and received either bilateral ESP (group 'E') or bilateral OSTAP (group 'O'). Those in group E received the block at the T7 level, and those in group O received the block in the subcostal region, with 20 ml of 0.2% ropivacaine and 4 mg of dexamethasone. The procedures were done after securing the airway. The total analgesic requirement and visual analogue scale (VAS) scoring in the first 24 hours post-operatively were observed, along with intra-operative opioid consumption. The opioid requirement, block-related complications, and patient feedback regarding post-operative pain control were also assessed. The results were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 23.0 (IBM Corp., Armonk, NY). Continuous and categorical data were analyzed using appropriate statistical analysis. A p-value
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.35750