Erector Spinae Plane Block for Pain Management in Hepatocellular Carcinoma Patients Undergoing Laparoscopic Left Hemihepatectomy: A Retrospective Propensity Score-matched Study.

Abstract

Objective: The objective of this investigation was to ascertain the effectiveness of an ultrasound-guided erector spinae plane block (ESPB) administered to patients diagnosed with hepatocellular carcinoma who were subjected to laparoscopic left hemihepatectomy.

Methods: A retrospective analysis was conducted on 172 patients, comparing 2 groups: one comprising 90 individuals who were administered intravenous patient-controlled analgesia (PCA) simultaneously with ESPB, and a second group of 82 patients who received PCA monotherapy. To equilibrate covariates across the groups, propensity score matching was executed, yielding 25 matched pairs as a result.

Results: At 12 and 24 hours postprocedure, visual analog scale (VAS) pain scores, both at rest and during movement, were significantly reduced in the group receiving PCA in conjunction with ESPB. Furthermore, this group exhibited a substantially lower incidence of rescue analgesia utilization, a significantly abbreviated duration to ambulation, a reduced hospitalization period, and a significantly elevated level of patient satisfaction.

Conclusion: ESPB serves as an efficacious ancillary analgesic for laparoscopic left hemihepatectomy, offering superior pain management and recuperation relative to the administration of intravenous analgesia in isolation. The implementation of ESPB as an adjunct to PCA in patients with hepatocellular carcinoma undergoing laparoscopic left hemihepatectomy proved to be both safe and efficacious. Notably, PCA augmented with ESPB demonstrated greater efficacy in mitigating postoperative pain compared with PCA as a standalone therapy.