Evaluation of Ultrasound‑Guided Erector Spinae Plane Block Versus Oblique Subcostal Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy: A Comparative Study.

Abstract

Background: Many inter-fascial plane blocks, including the oblique subcostal transversus abdominis plane (OSTAP) block and, more recently, the erector spinae plane (ESP) block, have been utilized as part of multimodal analgesia in numerous abdominal surgeries.

Objectives: This study aimed to evaluate the impact of using the OSTAP block and the ESP block as components of a multimodal analgesic technique in individuals undergoing laparoscopic cholecystectomy (LC).

Methods: This randomized, controlled, single-blinded clinical study was conducted on 50 individuals aged 20 to 60 years, of both genders, with American Society of Anesthesiology (ASA) grade I and II physical status, undergoing LC. Subjects were allocated using a computer-generated randomization table into two equal groups: Group A received an ultrasound (US)-guided ESP block, and group B received a US-guided OSTAP block.

Results: The Visual Analog Scale (VAS), mean arterial pressure (MAP), heart rate (HR), and respiratory rate (RR) at 6, 8, and 10 hours were significantly higher in the OSTAP block group compared to the ESP block group (P < 0.05). The time to the first morphine dose was significantly longer in the ESP block group compared to the OSTAP block group (P = 0.001). The total amount of morphine used was significantly greater in the OSTAP block group compared to the ESP block group. The incidence of nausea and vomiting did not differ significantly between the groups.

Conclusions: Bilateral US-guided ESP blocks provide superior and prolonged postoperative analgesia and require less morphine use compared to OSTAP blocks following LC.