Bilateral Erector Spinae Plane Block Versus Bilateral Oblique Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia in Colorectal Surgery

Ultrasound-Guided Bilateral Erector Spinae Plane Block Versus Bilateral Oblique Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia in Colorectal Surgery: A Prospective Randomized Study.

This study aims to compare the ultrasound-guided bilateral erector spinae plane block (ESPB) and oblique subcostal transverse abdominal plane block (OSTAPB) for postoperative analgesia in colorectal surgery.

Colorectal surgery remains the therapeutic cornerstone for the management of a wide variety of gastrointestinal disorders encompassing malignancies and inflammatory conditions.

Oblique subcostal transverse abdominal plane block (OSTAPB) is a regional block technique that involves injecting local anesthetics between the transverse abdominal muscle plane and the internal oblique abdominal muscle plane.

Ultrasound-guided erector spinae plane block (ESPB) is a novel technique that specifically targets the ventral rami, dorsal rami, and rami communicantes of the spinal nerves. Local anesthetic agents were observed to extend cranially and caudally over numerous dermatomal levels following injection.

Inclusion Criteria:

• Age 18 to 75 years old.
• Both sexes.
• American Society of Anesthesiologists (ASA) physical status II-III.
• Scheduled for open colorectal surgery under general anesthesia.

Exclusion Criteria:

• History of opioid abuse.
• Chronic opioid consumption.
• Body mass index (BMI) ≥ 35 kg/m2.
• Severe cardiac insufficiency, defined as New York Heart Association (NYHA) class III or IV heart failure.
• Renal failure, defined as an estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m².
• Hepatic encephalopathy.
• Having a skin infection at or near the puncture site.
• Coagulopathy, defined as platelet count < 100,000/mm³, INR > 1.5, or use of anticoagulant therapy that could not be withheld.
• Allergy to drugs used in the study.
• History of previous or recurrent laparoscopic cholecystectomy procedures.