EVALUATION OF ULTRASOUND-GUIDED ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA IN LAPAROSCOPIC CHOLECYSTECTOMY: A PROSPECTIVE, COMPARATIVE STUDY

Background: Erector Spinae Plane Block (ESPB) is a peri-paravertebral regional anesthetic technique that has since been reported as an effective technique for the prevention of postoperative pain in various surgeries. ESPB is performed under ultrasonographic guidance, provides extensive analgesia with a single puncture. Methodology: This study was conducted on 50 patients between 20 to 65 years old, ASA I and II, undergoing laparoscopic cholecystectomy under general anesthesia. They were randomly divided into two equal groups. Group A received Erector Spinae Plane Block (ESPB) and group B received no intervention before induction. Intraoperatively the patients were assessed for vitals at the time of trocar placement, CO2 insufflation, gallbladder extraction, extubation and postoperatively for vitals, NRS at rest, NRS with cough, Postoperative nausea vomiting (PONV) and shoulder pain at 20, 40, 60 mins, 3, 6, 12, 18 and 24 hrs. Results: The NRS at rest and NRS with cough were found to be lower and statistically significant in the group A till 24 hrs of postoperative period. The difference in total routine and rescue analgesia between the two groups over 24 hrs was statistically significant. In group A, 10 patients skipped one dosage of Paracetamol as their NRS was < 2/10 and refused pain medication. Even though number of patients having PONV was lesser in group A, the difference was not statistically significant. Shoulder pain was absent in group A, but was statistically significant only at 20, 40, 60 mins. Conclusion: The present study has shown that bilateral single shot ultrasound guided ESPB with 0.375% Bupivacaine performed in patients undergoing laparoscopic cholecystectomy decreases postoperative (static and dynamic) pain intensity in addition to the requirement for opioids and other analgesic agents.