ANKMJ

Ankyra Medical Journal (AnkMJ), formerly known as the Journal of Translational and Practical Medicine, regularly publishes international quality issues in the field of Medicine in the light of current information.

EndNote Style
Index
Original Article
Efficiency of erector spinae plane block with ultrasonography in laparoscopic cholecystectomy
Aims: The aim of our study is to evaluate the effects of ultrasound – guided erector spinae plane block (ESPB) on intraoperative opioid requirement, postoperative analgesic consumption and patient satisfaction in laparoscopic cholecystectomy (LC) procedures.
Methods: Ninety patients aged 18–65 years with American Society of Anesthesiologists (ASA) risk classification I–III who underwent elective laparoscopic cholecystectomy between December 2018 and December 2020 were retrospectively analyzed. Patients were divided into three groups: control (no block), preoperative ultrasound-guided ESPB, and postoperative ESPB performed just before extubation. Intraoperative opioid consumption, postoperative Visual Analog Scale (VAS) scores, additional analgesic requirements, and patient satisfaction were evaluated.
Results: There were no significant differences among the groups regarding age, sex, height, or ASA physical status (p > 0,05). However, significant differences were observed in mean body weight and body mass index (BMI) values (p = 0.006 and p = 0.007, respectively). Pairwise comparisons revealed no significant differences in body weight or BMI between the preoperative and postoperative ESPB groups (p = 0.787 and p = 0.882); however, both block groups had significantly higher values compared with the control group (p < 0.05). VAS scores, postoperative analgesic requirements, and patient satisfaction differed significantly among the groups at postoperative 0, 1, 2, 6, 12, and 24 hours, in favor of both ESPB groups (p < 0.001). Postoperative VAS scores at 0, 1, 2, and 6 hours were significantly lower in the preoperative ESPB group compared with the postoperative ESPB group (p < 0.001). Intraoperative opioid consumption and postoperative additional analgesic requirements were also significantly lower in the preoperative ESPB group than in the other two groups (p < 0.001). However, VAS scores and patient satisfaction at 12 and 24 hours were comparable between the two ESPB groups. In the control group, VAS scores at postoperative 0, 1, 2, 6, 12, and 24 hours were significantly higher (p < 0.001), resulting in a significantly greater need for additional analgesia.
Conclusion: Preemptive ESPB reduces the need for intraoperative opioids and maximizes patient satisfaction with postoperative low VAS scores.


1. Lee IO, Kim SH, Kong MH, et al. Pain after laparoscopic cholecystectomy: the effect and timing of incisional and intraperitoneal bupivacaine. Can J Anaesth. 2001;48(6):545-550. doi:10.1007/BF03016830
2. Kehlet H, Gray AW, Bonnet F, et al. A procedure-specific systematic review and consensus recommendations for postoperative analgesia following laparoscopic cholecystectomy. Surg Endosc. 2005;19(10):1396-1415. doi:10.1007/S00464-004-2173-8
3. Tulgar S, Selvi O, Kapakli MS. Erector Spinae plane block for different laparoscopic abdominal surgeries: case series. Case Rep Anesthesiol. 2018;2018:1-3. doi:10.1155/2018/3947281
4. Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The erector spinae plane block: a novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med. 2016;41(5):621-627. doi:10.1097/AAP. 0000000000000451
5. Tsui BCH, Fonseca A, Munshey F, McFadyen G, Caruso TJ. The erector spinae plane (ESP) block: a pooled review of 242 cases. J Clin Anesth. 2019;53:29-34. doi:10.1016/J.JCLINANE.2018.09.036
6. Thomas DT, Tulgar S. Ultrasound-guided erector spinae plane block in a child undergoing laparoscopic cholecystectomy. Cureus. 2018;10(2): e2241. doi:10.7759/CUREUS.2241
7. Elkoundi A, Bentalha A, El Kettani SEC, Mosadik A, Koraichi A El. Erector spinae plane block for pediatric hip surgery-a case report. Korean J Anesthesiol. 2019;72(1):68-71. doi:10.4097/KJA.D.18.00149
8. Singh S, Pandey R, Chowdhary N. Bilateral ultrasound-guided erector spinae plane block for postoperative analgesia in choledochal cyst resection surgery. Saudi J Anaesth. 2018;12(3):499-500. doi:10.4103/SJA.SJA_188_18
9. Altuntaş G, Akkaya ÖT, Özkan D, Sayın MM, Balas Ş, Özlü E. Comparison of intraabdominal and trocar site local anaesthetic infiltration on postoperative analgesia after laparoscopic cholecystectomy. Turk J Anaesthesiol Reanim. 2016;44(6):306-311. doi: 10.5152/TJAR.2016.75983
10. Vadivelu N, Mitra S, Schermer E, Kodumudi V, Kaye AD, Urman RD. Preventive analgesia for postoperative pain control: a broader concept. Local Reg Anesth. 2014;7(1):17-22. doi:10.2147/LRA.S62160
11. Rafiq S, Steinbrüchel DA, Wanscher MJ, et al. Multimodal analgesia versus traditional opiate based analgesia after cardiac surgery, a randomized controlled trial. J Cardiothorac Surg. 2014;9(1):52. doi:10. 1186/1749-8090-9-52
12. Alexander JI. Pain after laparoscopy. Br J Anaesth. 1997;79(3):369-378. doi:10.1093/BJA/79.3.369
13. Lee IO, Kim SH, Kong MH, et al. Pain after laparoscopic cholecystectomy: the effect and timing of incisional and intraperitoneal bupivacaine. Can J Anaesth. 2001;48(6):545-550. doi:10.1007/BF03016830
14. Labaille T, Mazoit JX, Paqueron X, Franco D, Benhamou D. The clinical efficacy and pharmacokinetics of intraperitoneal ropivacaine for laparoscopic cholecystectomy. Anesth Analg. 2002;94(1):100-105. doi: 10.1097/00000539-200201000-00019
15. Raetzell M, Maier C, Schroder D, Wulf H. Intraperitoneal application of bupivacaine during laparoscopic cholecystectomy--risk or benefit? Anesth Analg. 1995;81(5):967-972. doi:10.1097/00000539-199511000-00013
16. Yang HM, Choi YJ, Kwon HJ, O J, Cho TH, Kim SH. Comparison of injectate spread and nerve involvement between retrolaminar and erector spinae plane blocks in the thoracic region: a cadaveric study. Anaesthesia. 2018;73(10):1244-1250. doi:10.1111/ANAE.14408
17. Ivanusic J, Konishi Y, Barrington MJ. A cadaveric study investigating the mechanism of action of erector spinae blockade. Reg Anesth Pain Med. 2018;43(6):567-571. doi:10.1097/AAP.0000000000000789
18. Schwartzmann A, Peng P, Maciel MA, Forero M. Mechanism of the erector spinae plane block: insights from a magnetic resonance imaging study. Can J Anaesth. 2018;65(10):1165-1166. doi:10.1007/S12630-018-1187-Y
19. Tulgar S, Selvi O, Ahiskalioglu A, Ozer Z. Can unilateral erector spinae plane block result in bilateral sensory blockade? Can J Anaesth. 2019; 66(8):1001-1002. doi:10.1007/S12630-019-01402-Y
20. Aydin G, Aydin O. The Efficacy of ultrasound-guided paravertebral block in laparoscopic cholecystectomy. Medicina (Kaunas). 2018;54(5): 75. doi:10.3390/MEDICINA54050075
21. Chin KJ, Adhikary S Das, Forero M. Erector spinae plane (ESP) block: a new paradigm in regional anesthesia and analgesia. Curr Anesthesiol Rep. 2019;9(3):271-280. doi:10.1007/S40140-019-00333-0
22. Aksu C, Kus A, Yörükoglu HU, Kiliç CT, Gürkan Y. The effect of erector spinae plane block on postoperative pain following laparoscopic cholecystectomy: a randomized controlled study. J Anesth. 2019;27(1):9-14. doi:10.5222/JARSS.2019.14632
23. Altiparmak B, Toker MK, Uysal Aİ, Kuşçu Y, Demirbilek SG. Efficacy of ultrasound-guided erector spinae plane block for analgesia after laparoscopic cholecystectomy: a randomized controlled trial. Braz J Anesthesiol. 2019;69(6):561-568. doi:10.1016/J.BJAN.2019.09.001
24. Verma R, Srivastava D, Saxena R, et al. Ultrasound-guided bilateral erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy: a randomized controlled trial. Anesth Essays Res. 2020;14(2):226. doi:10.4103/AER.AER_41_20
25. Kot P, Rodriguez P, Granell M, et al. The erector spinae plane block: a narrative review. Korean J Anesthesiol. 2019;72(3):209-220. doi:10.4097/KJA.D.19.00012
26. Aydin G, Sahin AT, Gencay I, et al. Which is more effective for minimally invasive pectus repair: epidural or paravertebral block? J Laparoendosc Adv Surg Tech A. 2020;30(1):81-86. doi:10.1089/LAP. 2019.0403
Volume 5, Issue 1, 2026
Page : 1-9
_Footer