The Effects of Erector Spinae Plane Block Versus Incision Site Local Anesthetic Infiltration on Stress Hormone Response in Patients Undergoing Laparoscopic Cholecystectomy: Randomized Controlled Study.

Background: After laparoscopic cholecystectomy surgery, an increase in stress hormones and moderate-to-severe pain occur in the postoperative period. The aim is to compare the effects of unilateral erector spinae plane block (ESPB) and port site local anesthetic (LA) infiltration methods on stress hormone response and postoperative pain in laparoscopic cholecystectomy operations.

Methods: This study was a prospective, randomized controlled, single-blind trial that divided laparoscopic cholecystectomy patients into 3 groups. In group I, local anesthetic infiltration was administered at 4 trocar sites; group E underwent unilateral ESPB guided by ultrasound; and group C was the control group with no intervention. Stress hormones were measured preoperatively and postoperatively, and postoperative VAS scores were recorded. The primary outcome was to compare the effects of LA infiltration and ESPB on stress hormone response, while the secondary outcome was the efficacy of postoperative analgesia.

Results: A total of 90 patients were included in the study. The duration of analgesia was significantly longer in group I compared with group C (P<0.05). Postoperative VAS scores were significantly lower in group E and group I than in group C (P<0.05). Group E significantly suppressed prolactin levels compared with the other 2 groups (P<0.05). In addition, group E significantly reduced glucose levels compared with group C (P<0.05).

Conclusion: Unilateral ESPB and infiltration have similar effects on pain and stress hormones after laparoscopic cholecystectomy. Infiltration may be preferred due to its easier application.