Ultrasound-guided unilateral versus bilateral erector spinae plane block for postoperative analgesia of patients undergoing laparoscopic cholecystectomy

TL;DR

This study compares unilateral and bilateral erector spinae plane blocks for pain management after laparoscopic cholecystectomy.

Contribution

The study evaluates the effectiveness of unilateral versus bilateral ESPB in postoperative analgesia for laparoscopic cholecystectomy.

Findings

Bilateral ESPB significantly reduced VAS scores at 6 hours post-surgery compared to the control group.

Bilateral ESPB significantly reduced tramadol use over 24 hours compared to the control group.

Abstract

Ultrasound-guided erector spinae plane block (ESPB) was originally developed for the treatment of neuropathic chest pain and has since been used in various thoracic, lumbar, and sacral surgeries.

This study aimed to establish whether unilateral or bilateral ESPB is more effective for pain management in laparoscopic cholecystectomy.

A total of 54 adult patients undergoing laparoscopic cholecystectomy were divided into three groups: unilateral ESPB, bilateral ESPB, and a control group (no ESPB). The unilateral ESPB group received 20 mL of 0.25% bupivacaine preoperatively at the T8 vertebral level. The bilateral ESPB group received 20 mL of 0.25% bupivacaine to both sides of the vertebra. The control group received no intervention, and all three groups received general anesthesia. Intraoperatively, all patients received 50 mg of dexketoprofen and 1 mg/kg of tramadol. Postoperative tramadol use and visual analog scale (VAS) scores were recorded at 0 min, 30 min, 2 h, 6 h, 12 h, and 24 h.

Demographic characteristics did not differ significantly between the groups. At the 6 h post-surgery, the VAS scores in the bilateral ESPB group were significantly lower than the control group (p < 0.001). Total tramadol use in 24 h was significantly lower in the bilateral ESPB group compared with the control group (p = 0.003).

Bilateral ESPB could be a valuable component of multimodal analgesia strategies in laparoscopic cholecystectomies.

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