Erector Spinae Plane (ESP) block as an Analgesic Alternative in Patients Undergoing Laparoscopic Cholecystectomy: A prospective Randomized Controlled study

Background: Laparoscopic cholecystectomy (LC) became a widespread procedure with less invasive technique for treatment of gallbladder diseases. LC is associated with moderate to severe pain despite all currently available conventional analgesic regimes. Erector Spinae Plane (ESP) block is reported to lead to analgesic effect on somatic and visceral pain. Objectives: evaluate the role of ESP block in control of post-operative pain following laparoscopic cholecystectomy and decrease the need to opioids and avoid their complications particularly postoperative nausea and vomiting (PONV), decrease duration of both Postanethestic care unit (PACU) and hospital stay. Patients and methods: This was a prospective clinical trial involved 60 adult patients divided into Group E (ESP group) received ultrasound guided ESP block and Group C (control group) received conventional analgesia with general anesthesia for both groups. Postoperative pain was measured using the Visual Analogue Scale (VAS), and postoperative opioid consumption and PONV and other complications, and duration of stay in both PACU and hospital all were recorded. Results: There was a significant decrease in group E when compared to group C regarding Follow up VAS score through the first day post-operative (p < 0.05). We found more opioid consumption in group C with mean 13.40±5.83 in comparison to a mean 2.40±4.05 for group E (P<0.05).Also results show less stay time in PACU or in hospital in group E with mean of 2.43± 0.504 hour and 2.27± 0.450 day respectively in comparison to group C. Conclusion: ESB provided better pain control, less opioid consumption and also less PACU and hospital stay than control group.