Ultrasound-Guided Erector Spinae Plane Block Versus Oblique Subcostal Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy

Helwan University50 enrolled

Overview

The aim of this work was to compare the effect of using oblique subcostal transversus abdominis plane (OSTAP) block and erector spinae plane (ESP) block as a part of multi-modal analgesia technique in patients undergoing laparoscopic cholecystectomy.

Laparoscopic cholecystectomy is a commonly performed surgery and requires multi-modal analgesia for better control of pain. Untreated post-operative pain has many consequences, including patient dissatisfaction, transition into chronic pain, delayed discharge from the hospital, and increased healthcare costs. Many inter-fascial plane blocks like oblique subcostal transversus abdominis plane (OSTAP) block and recently, erector spinae plane (ESP) block have been utilized as a part of multi modal analgesia technique in many abdominal surgeries.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Ultrasound Erector Spinae Plane Block Oblique Subcostal Transversus Abdominis Plane Block Laparoscopic Cholecystectomy

Interventions

Erector spinae plane blockOTHER

Patients received ultrasound-guided erector spinae plane block.

Oblique subcostal transversus abdominis plane blockOTHER

Patients received ultrasound-guided oblique subcostal transversus abdominis plane block.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age from 20 to 60 years. * Both gender. * American Society of Anesthesiologists (ASA) grade I and II physical status. * Body mass index (BMI): ≥ 20 kg/m2 and ≤ 35 kg/m2. * Underwent laparoscopic cholecystectomy. Exclusion Criteria: * Patient refusal. * Known sensitivity or contraindication to drugs used in the study (local anesthetics, opioids). * History of psychological disorders and/or chronic pain syndrome. * Contraindication to regional anesthesia, e.g., local sepsis, pre-existing peripheral neuropathies, and coagulopathy. * Severe respiratory disorders such as (severe obstructive pulmonary disease, forced expiratory volume (FEV1), forced vital capacity (FVC) \<50% or severe restrictive pulmonary disease, and adult respiratory distress syndrome). * Severe cardiac disorders such as (heart failure). * Advanced liver disease (elevated liver enzymes more than 3 folds of normal range). * Advanced kidney disease (Decreased creatinine clearance \<40 ml/min). * Pregnancy.

Locations (1)

Helwan University

Helwan, Cairo Governorate, Egypt

Outcomes

Primary Outcomes

Degree of pain intensity

The degree of pain intensity was assessed using the Visual Analogue Scale (VAS). Each patient was instructed about postoperative pain assessment with the VAS. VAS(0 represents "no pain" while 10 represents "the worst pain imaginable"). It was assessed at 30 minutes, 2, 4, 6, 8, 12, 16, 20, and 24 hours postoperatively.