• Der Anaesthesist · Dec 2021

    Randomized Controlled Trial

    Erector spinae plane block reduces pain after laparoscopic cholecystectomy.

    • Vladimir Vrsajkov, Nataša Ilić, Arsen Uvelin, Radomir Ilić, Mirka Lukić-Šarkanović, and Aleksandra Plećaš-Đurić.
    • Clinical Centre of Vojvodina, Hajduk Veljkova 1-7, 21000, Novi Sad, Serbia. vladimir.vrsajkov@gmail.com.
    • Anaesthesist. 2021 Dec 1; 70 (Suppl 1): 48-52.

    PurposeAfter laparoscopic cholecystectomy patients have moderate pain in the early postoperative period. According to several studies an erector spinae plane (ESP) block can be a valuable part of multimodal analgesia. Our intention was to evaluate how ESP block influences postoperative pain scores and opioid consumption after laparoscopic cholecystectomy.MethodsThis single-blinded, prospective, randomized study included 60 patients undergoing laparoscopic cholecystectomy to receive either bilateral ESP block at the Th 7 level (n = 30) with 20 ml of 0.25% levobupivacaine plus dexamethasone 2 mg per side, or standard multimodal analgesia (n = 30). Patients from the standard multimodal analgesia group received tramadol 100 mg at the end of the procedure. Postoperative analgesia for both groups was acetaminophen 1 g/8 h i.v. and ketorolac 30 mg/8 h. Tramadol 1 mg/kg was a rescue treatment for pain breakthrough (numeric rating scale/NRS ≥ 6) in both groups. Pain at rest was recorded at 10 min, 30 min, 2 h, 4 h, 8 h, 12 h and 24 h after surgery using NRS (0-10).ResultsAn ESP block significantly reduced postoperative pain scores compared to standard multimodal analgesia after 10 min (p = 0.011), 30 min (p = 0.004), 2 h (p = 0.011), 4 h (p = 0.003), 8 h (p = 0.013), 12 h (p = 0.004) and 24 h (p = 0.005). Tramadol consumption was significantly lower in the ESP group 25.02 ± 56.8g than in the standard analgesia group 208.3 ± 88.1g (p < 0.001).ConclusionAn ESP block can provide superior postoperative analgesia and reduction in opioid requirement after laparoscopic cholecystectomy.© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

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