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

Evaluation of Ultrasound-Guided Erector Spinae Plane Block Versus Oblique Subcostal Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy: A Comparative Study

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.

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.