Erector spinae block reduces intraoperative and postoperative opioid consumption in patients undergoing laparoscopic sleeve gastrectomy: A randomized controlled trial.

Abstract

Background: Obese patients are at increased risk of postoperative respiratory complications because of sedatives and opioids. The erector spinae block is a novel regional block that has been used in different surgeries. It offers an easier approach and a better safety profile. This study aimed to assess the role of erector spinae plane block (ESPB) in reducing postoperative pain scores and opioid consumption in patients undergoing sleeve gastrostomies.

Methods: Institutional committee approval was obtained for this randomized controlled trial. Inclusion criteria included patients aged between 18 and 65 years with American Society of Anesthesiologists (ASA) scores 1-3 who were scheduled to undergo laparoscopic sleeve gastrectomy under general anesthesia. Simple randomization using sealed opaque envelopes was used to allocate study patients to either of the two groups. The intervention group received erector spinae block using 0.2% ropivacaine just after induction of anesthesia while the control group did not receive a block. Primary outcome variables were pain scores during the first 24 hours after surgery.

Results: A total of 60 patients were included in the study. There was no significant difference in the baseline characteristics between two groups. Numerical rating scale (NRS) pain scores in the postoperative period were lower in the ESPB group but there was no statistical significance. Intraoperative remifentanil consumption was statistically lower in the ESPB group compared to the control group (P < 0.01). ESPB also reduced 24-hour opioid consumption (P = 0.002). There was no statistical difference in the incidence of adverse events between the two groups.

Conclusion: The use of ESPB in laparoscopic sleeve gastrectomy patients is associated with a significant reduction in intraoperative and 24-hour postoperative opioid consumption.

Trial registration id: The trial was registered with Clinicaltrials.gov as trial ID-NCT04368195.