The effect of erector spinae plane block on postoperative analgesia and respiratory function in patients undergoing laparoscopic cholecystectomy: A double-blind randomized controlled trial.

Abstract

STUDY OBJECTIVE\nLaparoscopic cholecystectomy (LC) causes moderate-to-severe postoperative pain. Postoperative pain is one of the leading contributors to respiratory dysfunction following surgery. This study investigated the effect of erector spinae plane (ESP) block on postoperative analgesia and respiratory function in patients undergoing LC.\n\n\nDESIGN\nProspective, randomized, controlled trial.\n\n\nSETTING\nUniversity of Health Science.\n\n\nPATIENTS\nSixty-eight adult patients undergoing LC.\n\n\nINTERVENTIONS\nBoth groups received a standardized analgesia protocol. Patients assigned to the ESP block group received an additional bilateral ESP block.\n\n\nMEASUREMENTS\nThe primary outcome was assessed as postoperative pain intensity associated with a lower opioid requirement and significant respiratory function improvement.\n\n\nMAIN RESULTS\nNumerical rating scale (NRS) scores both at rest and during coughing were significantly lower in the ESP block group than in the control group at all time intervals (p\xa0<\xa00.001 in each) except for hour 2 postoperatively (p\xa0=\xa00.06 and p\xa0=\xa00.13, respectively). Tramadol consumption at 2\xa0h and 24\xa0h postoperatively was significantly lower in the ESP block group than in the controls (p\xa0<\xa00.001 for each). There was significant preservation in forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) in the ESP group in comparison to the control group at 2 and 24\xa0h after surgery (p\xa0<\xa00.05 in each). FEV1/FVC and peak expiratory flow rate (PEFR) values were similar in each time interval.\n\n\nCONCLUSIONS\nBilateral ESP blocks provides adequate analgesia, allowing for a lower opioid requirement and significant respiratory function improvement after LC; therefore, we concluded that ESP block could be added to the multimodal analgesia protocol in LC.