Efficacy of Erector Spinae Block Versus Transversus Abdominis Plane Block in Post Operative Pain Control After Laparoscopic Cholecystectom

Objective: To compare post-operative analgesic efficacy of ultrasound guided erector spinae block versus transversus abdominis plane block in patients undergoing laparoscopic cholecystectomy. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Anesthesia, Combined Military Hospital, Rawalpindi Pakistan, from May to Oct 2022. Methodology: Our patients were divided into erector spinae block Group (Group ESP) (n=20) and transversus abdominis plane block Group (Group TAP) (n=20). After the surgery, before extubating, a consultant anesthetist with at least 5 years of regional block experience, performed the blocks in selected patients under ultrasound guidance following standard techniques and protocols. Results: Duration of surgery between both Groups was comparable, with a mean time of 128.5±5.1 minutes in the ESP versus 127.3±5.7 minutes in the TAP Group (p=0.13). However, time to first rescue analgesia was significantly increased in ESP Group at 238.5±5.1 minutes versus 174.1±6.0 minutes in TAP Group (p=0.0001). Consequently, total analgesia requirement was also significantly decreased in ESP Group with 4.6±0.5 mg in 24 hours versus 8.2±0.9 mg in 24 hours in TAP Group (p=0.0001). Mean HDU stay was also decreased significantly between ESP and TAP Group, being 27.8± 2.3 hours versus 44.25±5.5 hours (p=0.0001). Conclusion: ESP block provides superior analgesia, good adverse effect profile, early mobilization and decreased hospital stay when compared to TAP block for laparoscopic cholecystectomy.